高强度聚焦超声对子宫肌瘤患者卵巢及免疫功能的影响

Effects of high intensity focused ultrasound on ovarian and immune function of patients with uterine fibroids

目的:观察高强度聚焦超声(HIFU)治疗子宫肌瘤的临床疗效及对患者卵巢、免疫功能的影响。方法:根据手术方式的不同,将132例子宫肌瘤患者分为HIFU组(60例)、肌瘤剔除组(39例)和全子宫切除组(33例)。比较各组术前、术后6个月时血红蛋白浓度、月经周期、子宫内膜厚度、卵巢及免疫功能。结果:与术前比较,术后6个月各组血红蛋白浓度显著升高,HIFU组、肌瘤剔除组月经周期显著缩短,肌瘤剔除组子宫内膜显著变薄(P<0.05),HIFU组子宫内膜显著厚于肌瘤剔除组(P<0.05);术后6个月全子宫切除组的促卵泡激素(FSH)、黄体生成素(LH)水平较术前显著升高,雌二醇(E2)水平显著降低,与HIFU组、肌瘤剔除组比较,差异均有统计学意义(P<0.05)。术后6个月,HIFU组的各项免疫功能指标显著高于肌瘤剔除组和全子宫切除组(P<0.05)。结论:HIFU对子宫肌瘤患者卵巢和免疫功能无明显影响,在符合手术指征的前提下,可作为子宫肌瘤的首选治疗方法。

Objective:To observe the clinical efficacy of high intensity focused ultrasound(HI FU)in treating uterine fibroids and its effects on patients’ovarian and immune functions.Methods:132 patients with uterine fibroids were divided into HIFU group(60 cases),myomectomy group(39 cases)and hysterectomy group(33 cases)according to different surgical procedures.The hemoglobin concentrations,menstrual cycle,endometrial thickness,ovarian and immune fuinction before operation and 6 months after operation were measured.Results:Compared with the preoperative results,the hemoglobin concentrations in each group were increased significantly at 6 months after operation,menstrual cycle of HIFU group and myomectomy group were shortened significantly,endometrium of myomectomy group was thinner significantly(P<0.05),endometrium of HIFU group was significantly thicker than that of myomectomy group(P<0.05),the follicle-stimulating hormone(FSH)and luteinizing hormone(LH)at 6 months after operation in hysterectomy group were significantly higher and estradiol(E2)was significantly lower,FSH and LH in hysterectomy group were significantly different from those in HIFU group and fibroid-elimination group(P<0.05).At 6 months after operation,the immune function indicators in HIFU group were significantly higher than that in myomectomy group and hysterectomy group(P<0.05).Conclusion:HIFU has no significant effect on ovarian and immune function in patients with uterine fibroids,and HIFU can be used as the preferred treatment for uterine fibroids under the premise of the surgical indications.