腹腔镜下病灶切除联合子宫动脉阻断术对子宫腺肌病患者MMP-2 MMP-3 MMP-9及CA125水平的影响  

Effects of laparoscopic lesion resection combined with uterine artery blockage on serum levels of MMP-2,MMP-3,MMP-9 and CA125 in patients with adenomyosis

作　　者：王东阁 季丽梅 贾涔琳 邵明君 WANG Dong-ge;JI Li-mei;JIA Cen-lin;SHAO Ming-jun(Department of Gynecology,Jinhua Central Hospital,Jinhua,Zhejiang 321000,China;不详)

机构地区：[1]金华市中心医院妇科,浙江金华321000 [2]金华市妇幼保健院妇科

出　　处：《中国妇幼保健》2024年第2期367-371,共5页Maternal and Child Health Care of China

基　　金：浙江省金华市科学技术局项目(2021-3-126)。

摘　　要：目的探讨腔镜下病灶切除联合子宫动脉阻断术对子宫腺肌病(AM)患者血清基质金属蛋白酶-2(MMP-2)、基质金属蛋白酶-3(MMP-3)、基质金属蛋白酶-9(MMP-9)及糖链抗原125(CA125)水平的影响。方法选取2019年1月—2021年7月就诊于金华市中心医院的100例子宫腺肌病(AM)患者为研究对象,随机数字表法分为对照组50例和观察组50例,对照组行腹腔镜下病灶切除,观察组在其基础上联合子宫动脉阻断术(UAB),两组均随访12个月。比较两组手术时间、术中出血量及术后排气时间;临床疗效和复发率;子宫体积、痛经程度、经期及经量;MMP-2、MMP-3、MMP-9及CA125水平。结果与对照组比较,观察组手术时间显著延长[(67.24±12.47)min vs.(49.67±10.87)min],术中出血量[(81.88±13.68)ml vs.(129.21±29.59)ml]、术后排气时间[(19.61±4.29)ml vs.(25.23±5.73)ml]显著减少(P<0.05);与对照组(78.00%、22.00%)比较,观察组临床总有效率(94.00%)显著升高,复发率(4.00%)显著降低(P<0.05);治疗后两组子宫体积、痛经程度、经期及经量显著减少,且观察组子宫体积[(106.36±19.59)cm^(3) vs.(126.86±23.03)cm^(3)]、痛经程度[(0.51±0.13)分vs.(1.92±0.47)分]、经量[(45.87±14.79)%vs.(57.51±14.84)%]显著少于对照组(P<0.05);与治疗前比较,治疗后两组血清MMP-2、MMP-3、MMP-9及CA125水平显著降低,且观察组血清MMP-2[(116.43±18.22)mg/L vs.(220.19±19.23)mg/L]、MMP-3[(110.30±17.11)mg/L vs.(194.30±17.20)mg/L]、MMP-9[(108.72±12.23)mg/L vs.(168.49±29.79)mg/L]、CA125[(31.59±4.92)U/ml vs(61.70±6.73)U/ml]水平显著低于对照组(P<0.05)。结论腔镜下病灶切除联合UAB治疗AM虽会延长手术时间,然而其治疗效果显著,同时还能下调患者血清MMP-2、MMP-3、MMP-9及CA125水平,具有较高的临床参考价值。Objective To investigate the effect of laparoscopic lesion resection combined with uterine artery blockage on serum matrix metalloproteinase-2(MMP-2),matrix metalloproteinase-3(MMP-3),matrix metalloproteinase-9(MMP-9)and carbohydrate antigen 125(CA125)levels in patients with adenomyosis.Methods A total of 100 patients with adenomyosis(AM)who were treated in our hospital from January 2019 to July 2021 were selected as the research objects.According to the random number table method,they were divided into a control group of 50 cases and an observation group of 50 cases.The group underwent laparoscopic lesion resection,and the observation group was combined with uterine artery blockage(UAB)on the basis of it.Both groups were followed up for 12 months.The operation time,intraoperative blood loss,postoperative exhaust time;clinical efficacy and recurrence rate;uterine volume,degree of dysmenorrhea,menstrual period,menstrual volume;serum MMP-2,MMP-3,MMP-9 and CA125 levelswere compared between the two groups.Results Compared with the control group,the operation time of the observation group was significantly prolonged[(67.24±12.47)min vs.(49.67±10.87)min],the intraoperative blood loss[(81.88±13.68)ml vs.(129.21±29.59)ml],and postoperative drainage Gas time[(19.61±4.29)ml vs.(25.23±5.73)ml]was significantly reduced(P<0.05);Compared with the control group(78.00%,22.00%),the clinical total effective rate(94.00%)of the observation group was significantly increased,and the recurrence rate(4.00%)was significantly decreased(P<0.05);Compared with before treatment,the uterine volume,degree of dysmenorrhea,menstrual period,and menstrual volume in the two groups were significantly decreased after treatment,and the uterine volume of the observation group[(106.36±19.59)cm^(3) vs.(126.86±23.03)cm^(3)],the degree of dysmenorrhea[(0.51±0.13)points vs.(1.92±0.47)points]and menstrual volume[(45.87±14.79)%vs.(57.51±14.84)%]were significantly lower than those in the control group(P<0.05);Compared with before treatment,the serum

关 键 词：腔镜下病灶切除 子宫动脉阻断术 子宫腺肌病 基质金属蛋白酶类 糖链抗原125 

分 类 号：R713[医药卫生—妇产科学]