子宫腺肌症患者的血清雌二醇水平与病情严重程度相关性分析

A Correlation Analysis Between Serum Estradiol Levels and Severity of Adenomyosis in Patients

目的探讨子宫腺肌症患者的血清雌二醇水平与病情严重程度相关性。方法选取2021年6月至2023年10月在济南市第五人民医院妇科行子宫切除术的50例子宫腺肌症患者作为观察组,取同期健康女性50例作为对照组。根据病理结果将子宫腺肌症分型,分别为轻微型、局限型、严重型;采用化学发光免疫分析仪检测两组研究对象血清雌二醇水平;COX痛经症状量表(CMSS)评估两组研究对象痛经程度,得分越高表示痛经越严重;术前经阴道彩超测定两组研究对象子宫前后径、长径、横径,计算子宫体积。结果与对照组比较,观察组研究对象血清雌二醇水平、CMSS评分、子宫体积升高(P<0.05);两组研究对象血清雌二醇水平与CMSS评分、子宫体积均呈正相关性(r=0.345,P<0.001、r=0.302,P=0.002);与轻微型子宫腺肌症比较,局限型子宫腺肌症研究对象血清雌二醇水平升高(P<0.05),与局限型子宫腺肌症比较,严重型子宫腺肌症研究对象血清雌二醇水平升高(P<0.05);ROC曲线分析血清雌二醇水平对子宫腺肌症不同分型的灵敏度及特异性分析发现,对子宫腺肌症轻微型、局限型诊断效果的灵敏度、特异性及AUC均相差不大,对严重型的诊断效果最好。结论子宫腺肌症患者的血清雌二醇水平与病情严重程度呈正相关,血清雌二醇水平越高,子宫腺肌症病情越重,检测血清雌二醇水平对子宫腺肌症的早期诊治有重要指导意义。

Objective To explore the correlation between serum estradiol levels and the severity of uterine adenomyosis in patients.Methods 50 patients with adenomyosis who underwent hysterectomy in the Department of Gynecology of Jinan Fifth People’s Hospital from June,2021 to October,2023 were selected as the observation group,while 50 healthy women during the same period were selected as the control group.According to the pathological results,adenomyosis of uterus was divided into mild,limited and severe types.Serum estradiol levels were detected by chemiluminescence immunoassay.COX dysmenorrhea Symptom Scale(CMSS)was used to assess the degree of dysmenorrhea in both groups:the higher the score,the more severe the dysmenorrhea.The anterior and posterior diameter,long diameter and transverse diameter of uterus were measured by vaginal ultrasonography before operation,and the volume of uterus was calculated.Results Compared with the control group,the serum estradiol level,CMSS score,and uterine volume of the study subjects in the observation group increased significantly(P<0.05);There was a positive correlation between serum estradiol levels,CMSS scores,and uterine volume in both groups(r=0.345,P<0.001,r=0.302,P=0.002);Compared with mild adenomyosis,subjects with localized adenomyosis had elevated serum estradiol levels(P<0.05),while compared with localized adenomyosis,subjects with severe adenomyosis had elevated serum estradiol levels(P<0.05);ROC curve showed that the sensitivity,specificity and AUC of mild and limited types of uterine adenomyosis were not different,and the diagnosis performance of severe types was the best.Conclusion The serum estradiol level in patients with adenomyosis is positively correlated with the severity of the condition.The higher the serum estradiol level,the more severe the condition of adenomyosis.Targeting serum estradiol levels has an important guiding significance for the early diagnosis and treatment of adenomyosis.