GnRH-a、曼月乐联合HIFU治疗子宫腺肌病的效果及对患者TGF-β2水平的影响  

Effect of GnRH-a and Mirena combined with HIFU on TGF-β2 in patients with adenomyosis

作　　者：胡轶华 彭娟[2] Hu Yihua;Peng Juan(Department of Obstetrics and Gynecology,Changyuan Maternal and Child Health Hospital,Changyuan Henan 453400,China;Department of Pelvic Floor Reconstruction,The Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]长垣市妇幼保健院妇产科,河南长垣453400 [2]郑州大学第三附属医院盆底重建科,郑州450000

出　　处：《保健医学研究与实践》2023年第7期67-72,86,共7页Health Medicine Research and Practice

摘　　要：目的探讨促性腺激素释放激素激动剂(GnRH-a)、曼月乐联合高强度聚焦超声(HIFU)治疗子宫腺肌病(AM)的近期疗效及对转化生长因子β2(TGF-β2)水平的影响。方法采用GSE88911阵列鉴定TGF-β2激活的AM相关标志物。选取2018年1月—2020年1月长垣市妇幼保健院妇产科收治的54例中重度AM患者作为研究对象,按入院先后顺序采用交替分组法分为对照组和观察组,每组27例。对照组患者给予GnRH-a+曼月乐治疗,观察组患者在对照组基础上加用HIFU治疗。比较2组患者治疗前后血清TGF-β2、氯离子通道蛋白6(CLIC6)水平、痛经视觉模拟评分法(VAS)评分、经量评分、血红蛋白水平、病灶体积、子宫体积、血清CA125水平等;比较2组患者的疗效以及随访期间并发症发生情况。结果差异性基因表达比较结果发现,CLIC6显著上调。蛋白-蛋白相互作用网络(PPI)分析发现,CLIC6的中心性最高,与其他蛋白联系紧密。治疗前,2组患者血清TGF-β2、CLIC6水平、痛经VAS评分、经量评分、血红蛋白水平、病灶体积、子宫体积、血清CA125水平比较,差异均无统计学意义(P>0.05)。治疗后,2组患者血清TGF-β2、CLIC6水平均低于治疗前,且观察组患者低于对照组,差异均有统计学意义(P<0.05)。治疗后,2组患者痛经VAS评分和经量评分均明显降低,且观察组低于对照组,差异均有统计学意义(P<0.05);2组患者血红蛋白水平均明显升高,且观察组高于对照组,差异均有统计学意义(P<0.05)。治疗后,2组患者的病灶体积和子宫体积均显著减小,且观察组小于对照组,差异均有统计学意义(P<0.05)。治疗后,2组患者血清CA125水平均有所降低,且观察组低于对照组,差异均有统计学意义(P<0.05)。治疗后6个月,观察组治疗效果优于对照组,差异具有统计学意义(P<0.05)。随访期间,2组患者的并发症总发生率比较,差异无统计学意义(P>0.05)。结论Gn-RH-a、曼月乐联合HIFU�Objective This paper aims to investigate the short-term therapeutic efficacy of gonadotropin-releasing hormone agonist(GnRH-a),Mirena combined with high-intensity focused ultrasound(HIFU)in treating adenomyosis(AM)and their effects on transforming growth factorβ2(TGF-β2).Methods GSE88911 array was used to identify AM-related markers of TGF-β2 activation.A total of 54 patients with moderate to severe AM admitted to the Department of Obstetrics and Gynecology of Changyuan Maternal and Child Health Hospital from January 2018 to January 2020 were selected as the study participants.They were assigned to the control group and the observation group by the alternating grouping method following the order of admission,with 27 cases in each group.The control group was treated with GnRH-a combined with Mirena,and the observation group was treated with HIFU based on the control group.The serum TGF-β2,chloride intracellular channel protein 6(CLIC6)levels,visual analog scale(VAS)score for dysmenorrhea,menstrual volume score,hemoglobin level,lesion volume,uterine volume,and serum CA125 level were compared between the two groups before and after treatment.The therapeutic efficacy and complications during follow-up were compared between the groups.Results CLIC6 was significantly up-regulated in different gene expression.Protein-protein interaction(PPI)network analysis revealed that CLIC6 has the highest centrality and is closely linked to other proteins.Before treatment,there were no significant differences in serum TGF-β2,CLIC6 levels,VAS score for dysmenorrhea,menstrual volume score,hemoglobin level,lesion volume,uterine volume,and serum CA125 level between the two groups(P>0.05).After treatment,the serum TGF-β2 and CLIC6 levels in the two groups declined,and the patients in the observation group were lower than those in the control group,with statistical significance(P<0.05).After treatment,the VAS score for dysmenorrhea and menstrual volume score in the two groups were significantly decreased,and the observation group wa

关 键 词：促性腺激素释放激素激动剂 曼月乐 高强度聚焦超声 子宫腺肌病 转化生长因子Β2 

分 类 号：R711.74[医药卫生—妇产科学]