醋酸亮丙瑞林联合HIFU治疗子宫腺肌症的效果观察

Effect of leuprorelin acetate combined with high-intensity focused ultrasound for treating patients with adenomyosis

目的:观察醋酸亮丙瑞林(LA)联合高强度聚焦超声(HIFU)治疗子宫腺肌症(AM)的效果。方法:依据随机数字表法将60例AM患者分为两组,对照组30例予HIFU治疗,研究组30例予LA联合HIFU治疗。比较两组的子宫体积、病灶体积、月经状况、卵巢功能、不良反应、复发率,并检测血清糖链抗原125(CA125)、前列腺素2α(PGF2α)、脂联素水平。结果:治疗后两组子宫体积、病灶体积、痛经评分、经量评分、CA125、PGF2α均小或低于治疗前(P<0.05),且研究组小或低于对照组(P<0.05)。治疗后,两组的脂联素均高于治疗前(P<0.05),且研究组高于对照组(P<0.05)。治疗后,研究组的促卵泡激素(FSH)、促黄体生成素(LH)、雌二醇(E_(2))均低于治疗前(P<0.05),且研究组低于对照组(P<0.05)。研究组不良反应总发生率、随访6个月复发率较对照组差异无统计学意义(P>0.05)。结论:LA联合HIFU治疗AM可缓解患者痛经,改善经量、卵巢功能,缩小子宫体积、病灶体积,调节血清CA125、PGF2α、脂联素水平,且未增加不良反应、复发风险。

Objective: To observe the efficacy of leuprorelin acetate(LA) combined with high-intensity focused ultrasound(HIFU) for treating patients with adenomyosis(AM). Methods: According to the random number table method, 60 patients with AM were divided into two groups. 30 patients in the control group had received the treatment of HIFU, and 30 patients in the study group had received the treatment of LA combined with HIFU. The uterine volume, the lesion volume, the menstrual status, the ovarian function, the adverse reactions rate and the recurrence rate of AM of the patients were compared between the two groups. The levels of serum carbohydrate antigen 125(CA125), prostaglandin 2(PGF2α) and adiponectin of the patients in the two groups were detected. Results: The uterine volume, the lesion volume, the scores of dysmenorrheal and menstrual volume and the levels of CA125 and PGF2α of the patients in the two groups after treatment had decreased significantly(P<0.05), and which of the patients in the study group were significantly lower than those of the patients in the control group(P<0.05).The adiponectin level of the patients in the two groups after treatment had increased significantly(P<0.05), and which of the patients in the study group was significantly higher than that of the patients in the control group(P<0.05). The levels of follicle stimulating hormone(FSH), luteinizing hormone(LH) and estradiol(E_(2)) of the patients in the two groups after treatment had decreased significantly(P<0.05), and which of the patients in the study group were significantly lower than those of the patients in the control group(P<0.05). There were no significant differences in the total incidence of adverse reactions and the recurrence rate after 6 months of follow-up of the patients between the two groups(P>0.05). Conclusion: LA combined with HIFU for treating the patients with AM can alleviate their dysmenorrhea, improve their menstrual volume and ovarian function, reduce their uterine and lesion volumes, and which can regulate the serum CA125, PGF2α, and adiponectin levels of the patients, and without increasing the risk of their adverse reactions and their AM recurrence.