The Significance Of Estrogen Receptor、Progesterone Receptor And Nuclear Factor Kappab In The Pathogenesis Of Intrauterine Adhesions And The Clinical Anaalysis Of 155Casesof Intrauterine Adhesions Patients

Objective:Purpose To investigate the expression of estrogen receptor (ER)、progesterone receptor (PR)and nuclear factor kappa B (NF-k B) in the pathogenesis of intrauterine adhesion.Analyses the reason of clinical characteristics and occurrence of intrauterine adhesion, and to evaluation the effect of TCRA and the related factors affect its curative effect.Methods:Immunohistochemical method were used for detection of ER、PR and NF-k B in endometrial tissue both in the research group (IUA group, among them into light, medium and severe groups) and the control group (non IUA group). Retrospective study was employed to analyze the clinical data of TCRA of the 155 cases of patients during the period April 2013 to October 2015.Collect data including age, duration, menstrual conditions, uterine cavity operation(number), the endometrial thickness, adhesion degree and the range of the score, the scope of adhesion, adhesion separation times, adhesion separation methods.To evaluation the effect of TCRA and the related factors affect its curative effect.Results:1 The experiment part1.1 ER,PR,NF-kB in endometrial glandular epithelial cells and stromal cells were expressed, ER, PR is given priority to with the nucleus staining, NF-kB is given priority to with week nuclear cytoplasmic staining;1.2 ER expression in the IUA group was inferior than that in the non IUA group(P<0.05);in the IUA group, the degree of intrauterine adhesion have negative correlation relationship with the expression of ER (P<0.05);1.3 PR expression in the IUA group was inferior than that in the non IUA group(P<0.05);in the IUA group, the degree of intrauterine adhesion have no significant correlation with the expression of PR(P>0.05);1.4 NF-k B expression in the IUA group was higher than that in the non IUA group(P<0.05);in the IUA group, the degree of intrauterine adhesion have positive correlation relationship with the expression of NF-k B (P<0.05);1.5 In the IUA group, the expression of ER and expression of NF-k B has no obvious correlation (P> 0.05)。2 The case analysis partIntrauterine adhesion patients with abnormal menstruation accounted for 83.9% and due to the 22.6% reproductive dysfunction treatment.The intrauterine adhesion patients with a history of uterine cavity operation was 91.0%;among them 1 time accounted for 30.5%,among them 2 times accounted for 36.9%,among them 3 times and above accounted for 32.6%,83.2% of patients caused by uterine cavity operation is related to pregnancy.Menstrual abnormalities、the reason for the abortion may be associated with the degree of intrauterine adhesion (P<0.05).In follow-up to the 96 cases of patients, the total effective rate was 77.0%, The endometrial thickness,duration, adhesion severity,the scope and nature of caused by intrauterine adhesion were associated with the hysteroscopic curative effect(P<0.05).Multi-factor unconditioned Logistic regression, the results showed that the clinical course of patients is the independent factors influencing the hysteroscopic treatment of the clinical curative effect (P<0.05).Conclusion:1 The NF-k B high expression and ER, PR lower expression in endometrial tissue in the IUA groups may be related to the occurrence of a caused by intrauterine adhesion, it may become the IUA postoperative clinical predictors of hormone therapy efficacy.2 The heavier of the intrauterine adhesion degree, the lower the expression of ER, even for large doses of estrogen therapy after surgery, but the lack of combination with ER and poor therapeutic effect.3 Application for mild-to-moderate adhesion, individualized hormone therapy may be the expression of ER and PR in there was a raised effect.4 The mainly clinical manifestations of intrauterine adhesion were menstrual abnormalities and reproductive dysfunction,abnormal menstrual depending on the degree of intrauterine adhesion.The main cause of pregnancy of uterine cavity operation correlation is caused by intrauterine adhesion.Uterine cavity operation related to pregnancy is the main cause of intrauterine adhesion.5 The degree of intrauterine adhesion is related to the reason of the abortion, and severe IUA is more likely to be seen in the patients with missed abortion.6 The endometrial thickness,duration, ESGE dividing, adhesion of the scope and nature may affect the efficacy of hysteroscopy surgery.7 The treatment of intrauterine adhesion need to be comprehensive and individualized treatment, early diagnosis, early treatment, correct preoperative evaluation, avoid blind and excessive treatment.