中文摘要：

目的：探讨肥大细胞在雌激素介导的大鼠子宫内膜异位症模型中的作用及相关机制。方法：取健康雌性未孕SD大鼠24只，采用自体子宫内膜移植法建立大鼠腹壁子宫内膜异位症模型，按每天肌肉注射不同剂量雌激素将大鼠随机分成3组（每组8只）：大剂量组（雌激素200μg／kg＋双卵巢切除）、小剂量组（雌激素100μg／kg＋双卵巢切除）、模型对照组（仅作子宫内膜移植）。分别于造模后2周及4周后处死各组4只大鼠，采集血液和病灶组织标本，测量各组子宫内膜异位症病灶的大小，并对病灶组织进行苏木素—伊红（ HE）染色观察组织形态及角蛋白和波形蛋白免疫组织化学染色以鉴定造模是否成功。用甲苯胺蓝染色法检测各组大鼠病灶组织肥大细胞总数及脱颗粒肥大细胞数，酶联免疫吸附试验测定血清肿瘤坏死因子α水平，酶免疫分析法测定血清雌二醇水平，免疫组织化学染色法检测子宫内膜异位症病灶组织类胰蛋白酶、神经生长因子的表达水平。结果：两雌激素组2周和4周时血清雌二醇水平均大于模型对照组（均P＜0．05），4周时大剂量组血清肿瘤坏死因子α浓度大于模型对照组（ P＜0．05）；两雌激素组2周和4周病灶体积均大于模型对照组（均P＜0．05）；无论是2周还是4周，小剂量组甲苯胺蓝染色脱颗粒／肥大细胞总数比值均高于模型对照组（均P＜0．05）；4周时大剂量组神经生长因子的表达大于模型对照组（ P＜0．05）。结论：雌激素可促进子宫内膜异位症病灶的生长，其机制可能与激活肥大细胞脱颗粒相关，而后者可能与子宫内膜异位症模型大鼠血清肿瘤坏死因子α、神经生长因子水平升高有关。

英文摘要：

Objective： To investigate the role of mast cells in the pathogenesis of estrogen-mediated experimental endometriosis in rats .Methods： Endometriosis model was established by transplanting autologous fragments of uterus to the inner surface of the abdominal wall in 24 unpregnant female Sprague Dawley rats .The rats were divided randomly into three groups （ n =8 in each group ） , and were injected with different doses of estrogen：high-dose group（200 μg· kg^ -1· d^-1 ）, low-dose group（100 μg·kg^ -1· d^-1 ） and the control group （ 0 μg· kg ^-1· d ^-1 ） .The ovaries were surgically removed in high-dose and low-dose groups.Four rats were sacrificed in each group at 2 and 4 weeks after surgery .Their serum estradiol levels , size of lesions , total number of mast cells and degranulations , serum TNF-αlevels, expression of tryptase and NGF in tissues were analyzed and compared among groups .Results：The mean levels of serum estradiol 2 weeks and 4 weeks after model established and serum TNF-αat 4 weeks in estrogen-treated groups were significantly higher than those in control group （ all P 〈0 .05 ） .The mean size of endometriotic lesions in the estrogen-treated groups was also significantly larger than that in the control group 2 weeks and 4 weeks after model established （ all P〈0 .05 ） .Meanwhile , both at week 2 and week 4 , the mean ratio of degranulation/total number of mast cells by toluidine blue staining in low-dose estrogen group was significantly higher than that in the control group （ P〈0 .05 ） .The expression of NGF in high-dose estrogen group was significantly higher than that in the control group at week 4 （ P 〈0.05 ）.Conclusion： Estrogen can promote the growth of endometriotic lesions and may mediate the pathogenesis of endometriosis by activating mast cells, which may be associated with increasing TNF-αand NGF levels.