聚焦超声消融术联合地诺孕素治疗子宫腺肌病疗效及对免疫功能影响

Efficacy of the focused ultrasound ablation combined with dinorgestrel for treating patients with adenomyosis and its influence on the immune function

目的:探讨聚焦超声消融术(FUAS)联合地诺孕素对子宫腺肌病患者疼痛评分、贫血程度、血清指标、激素指标、免疫功能和安全性的影响。方法:将2022年11月-2023年11月本院诊治的子宫腺肌病86例,依据1:1比例随机分为对照组(n=43)和观察组(n=43),两组均采用FUAS治疗,观察组同时联合地诺孕素治疗,两组均治疗3个月。对比两组治疗前后疼痛评分、贫血程度、血清指标、激素指标、免疫功能,治疗不良反应。结果:治疗后观察组视觉模拟评分(1.47±1.03分)低于对照组(3.66±1.46分),血红蛋白(117.66±10.39g/L)、免疫球蛋白G(10.36±1.29g/L)、免疫球蛋白M(1.36±0.29g/L)水平高于对照组(107.52±9.22g/L、8.73±1.58g/L、0.89±0.21g/L),鼠双微基因2(1.44±0.39kU/L)、糖类抗原125(34.97±4.11IU/ml)、血管内皮生长因子(82.16±15.34pg/ml)、促卵泡激素(3.47±1.03U/L)、雌二醇(114.28±20.11pmol/L)、黄体生成素(4.27±1.05mg/ml)水平均低于对照组(2.36±0.47 kU/L、44.85±4.32IU/ml、98.46±17.28pg/ml、5.26±1.14U/L、134.69±21.20pmol/L、5.64±1.12mg/ml),不良反应发生率(9.3%)低于对照组(27.9%)(均P<0.05)。结论:FUAS联合地诺孕素治疗子宫腺肌病可有效减轻患者疼痛和贫血情况,改善血清因子指标、免疫功能和性激素指标,安全性较高。

Objective:To investigate the effects of the focused ultrasound ablation(FUAS)combined with dinorgestrel for treating patients with adenomyosis on their pain score,anemia degree,serum markers and hormone markers levels,immune function and safety.Methods:86patients with adenomyosis treated in hospital were randomly divided into control group(n=43)and observation group(n=43)according to 1:1ratio from November 2022to November 2023.The patients in the control group were treated with FUAS alone for 3months,and the patients in the observation group were treated with FUAS combined with dinorgestrel for 3months.The pain score,the degree of anemia,the levels of serum indexes and hormone indexes,the immune function and the adverse reactions rate of the patients before and after treatment were compared between the two groups.Results:After treatment,the visual analogue scale score(1.47±1.03points)of the patients in the observation group was significantly lower than that(3.66±1.46points)of the patients in the control group.The levels of hemoglobin(117.66±10.39g/L),immunoglobulin(Ig)G(10.36±1.29g/L)and IgM(1.36±0.29g/L)of the patients in the observation group were significantly higher than those(±9.22g/L,8.73±1.58g/L and 0.89±0.21g/L)of the patients in the control group.The levels of mouse double microgene-2(1.44±0.39kU/L),carbohydrate antigen 125(34.97±4.11IU/ml),vascular endothelial growth factor(82.16±15.34pg/ml),follicle stimulating hormone(3.47±1.03U/L),estradiol(114.28±20.11pmol/L)and luteinizing hormone(4.27±1.05mg/ml)of the patients in the observation group were significantly lower than those(2.36±0.47kU/L,44.85±4.32IU/ml,98.46±17.28pg/ml,5.26±1.14U/L,134.69±21.20pmol/L and 5.64±1.12mg/ml)of the patients in the control group.The incidence of adverse reactions(9.3%)of the patients in the observation group was significantly lower than that(27.9%)of the patients in the control group(all P<0.05).Conclusion:FUAS combined with dinorgestrel for treating the patients with adenomyosis can effectively reduce their pain degree and anemia status,improve their serum indexes,hormone indexes and immune function,and with the higher safety.