腹腔镜下子宫肌瘤剥除术对子宫肌瘤患者血清性激素、炎性因子及免疫功能的影响

Effect of laparoscopic myomectomy on serum sex hormones,inflammatory factors and immune function in patients with uterine fibroids

目的探讨腹腔镜下子宫肌瘤剥除术对子宫肌瘤患者血清性激素、炎性因子及免疫功能的影响。方法选取太谷县人民医院2014年1月至2017年5月治疗的子宫肌瘤患者100例为研究对象,采用随机数字表法分为对照组50例、观察组50例。对照组采用常规开腹子宫肌瘤剥除术,观察组采用腹腔镜下子宫肌瘤剥除术。比较两组患者术前、术后的血清促卵泡生成素(FSH)、黄体生成素(LH)、雌二醇(E2)、白细胞介素6(IL-6)、IL-10、肿瘤坏死因子α(TNF-α)水平和免疫功能。结果术后,观察组FSH、LH、IL-10、CD3+、CD4+、CD8+水平分别为(7.81±2.29)IU/L、(10.52±2.73)IU/L、(12.64±2.18)ng/L、(52.67±4.87)%、(31.56±3.82)%、(22.55±2.16)%,均高于对照组的(7.36±2.11)IU/L、(9.86±2.48)IU/L、(8.64±2.03)ng/L、(46.32±4.64)%、(27.62±3.78)%、(16.87±2.14)%,观察组的E2、IL-6、TNF-α水平分别为(65.56±5.45)ng/L、(13.67±3.56)ng/L、(23.58±4.05)ng/L,均低于对照组的(70.64±5.81)ng/L、(30.57±4.11)ng/L、(27.56±4.21)ng/L,两组均差异有统计学意义(t=2.542、2.589、9.495、6.675、5.184、13.209、4.509、21.977、4.817,均P<0.05)。结论腹腔镜下子宫肌瘤剥除术相比传统的开腹手术能更好地改善子宫肌瘤患者的FSH、LH、E2水平,缓解术后的的炎性反应,同时利于患者免疫功能快速恢复。

Objective To investigate the effect of laparoscopic myomectomy on serum sex hormones,inflammatory factors and immune function in patients with uterine fibroids.Methods From January 2014 to May 2017,100 patients with uterine fibroids who were treated in the People's Hospital of Taigu County were selected.The patients were divided into control group and observation group according to the random number table method,with 50 cases in each group.The control group was treated with conventional myomectomy,while the observation group was treated with laparoscopic myomectomy.The serum levels of follicle stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2),interleukin 6(IL-6),interleukin 10(IL-10),tumor necrosis factor-α(TNF-α)and immune function were compared before and after operation.Results The serum levels of FSH,LH,IL-10,CD3+,CD4+,CD8+in the observation group after operation were(7.81±2.29)IU/L,(10.52±2.73)IU/L,(12.64±2.18)ng/L,(52.67±4.87)%,(31.56±3.82)%,(22.55±2.16)%,respectively,which were higher than those in the control group[(7.36±2.11)IU/L,(9.86±2.48)IU/L,(8.64±2.03)ng/L,(46.32±4.64)%,(27.62±3.78)%,(16.87±2.14)%],the serum levels of E2,IL-6,TNF-αin the observation group after operation were(65.56±5.45)ng/L,(13.67±3.56)ng/L,(23.58±4.05)ng/L,which were lower than those in the control group[(70.64±5.81)ng/L,(30.57±4.11)ng/L,(27.56±4.21)ng/L],the differences were statistically significant(t=2.542,2.589,9.495,6.675,5.184,13.209,4.509,21.977,4.817,all P<0.05).Conclusion Compared with the traditional laparotomy,laparoscopic myomectomy can improve the levels of FSH,LH and E2 in patients with uterine fibroids,relieve postoperative inflammatory response,and improve the immune function of patients.