心理干预联合GnRH-a对卵巢子宫内膜异位症腹腔镜术后患者免疫功能及复发率的影响研究  

Effect of Psychological Intervention Combined with GnRH-a on Immune Function and Recurrence Rate of Patients with Ovarian Endometriosis After Laparoscopic Surgery

作　　者：韩涛[1] 马立娟 刘晓婉[1] Han Tao;Ma Lijuan;Liu Xiaowan(Gynecological Medical Diagnosis and Treatment Center of Xinjiang Uygur Autonomous Region People's Hospital,Urumqi,Xinjiang 830001,China.)

机构地区：[1]新疆维吾尔自治区人民医院妇科医学诊疗中心,新疆乌鲁木齐830001

出　　处：《四川医学》2024年第10期1108-1113,共6页Sichuan Medical Journal

基　　金：新疆维吾尔自治区人民医院基金项目(编号:GXBZX-2023003)。

摘　　要：目的探究心理干预联合促性腺激素释放激素(GnRH-a)对卵巢子宫内膜异位症腹腔镜术后患者免疫功能及复发率的影响。方法选取2021年6月至2023年5月就诊于我院接受腹腔镜手术治疗的卵巢子宫内膜异位症患者83例作为研究对象,随机分为GnRH-a干预组(n=41)和联合心理干预组(n=42)。GnRH-a干预组于术后给予GnRH-a治疗,联合心理干预组额外进行心理干预,所有患者均连续治疗6个月。对比两组患者一般临床资料、治疗前后免疫功能指标[抗子宫内膜抗体(AEmAb)、抗精子抗体(AsAb)、抗透明带抗体(AZpAb)]阳性率、负性情绪[汉密尔顿焦虑量表评分(HAMA),汉密尔顿抑郁量表评分(HAMD)]、性激素水平[促黄体生成素(LH)、卵泡刺激素(FSH)、雌二醇(E2)]及血清炎症因子[白细胞介素(IL)2、IL-6、C反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)]的水平变化;对比两组患者的疾病复发率。结果干预结束后两组患者AEmAb、AsAb、AZpAb阳性率、E2水平较干预前均显著降低,FSH、LH水平较干预前均显著增高(P<0.05),但两组间免疫功能指标、性激素水平比较差异均无统计学意义(P>0.05);干预结束后联合心理干预组患者平均HAMA、HAMD评分、血清TNF-α、IL-6水平均显著低于干预前和GnRH-a干预组(P<0.05);两组间复发率差异无统计学意义(P>0.05)。结论对于卵巢子宫内膜异位症腹腔镜术后患者联合应用GnRH-a及心理干预能显著改善患者负性情绪、自身免疫状态、性激素紊乱及全身炎症水平,进而降低患者的疾病复发率,提示心理干预可能具有协同GnRH-a改善卵巢子宫内膜异位症腹腔镜术后患者预后的积极作用,具有一定临床推广价值。Objective To investigate the impact of integrating psychological intervention with gonadotropin-releasing hormone(GnRH-a)on the immune function and recurrence rate among individuals with ovarian endometriosis following laparoscopic surgery.Methods Total 83 patients diagnosed with ovarian endometriosis who underwent laparoscopic surgery at our hospital between June 2021 and May 2023 were included in this study.They were randomly divided into two groups:the GnRH-a intervention group(n=41)and the combined psychological intervention group(n=42).The GnRH-a intervention group received GnRH-a treatment after the surgery,while the combined psychological intervention group received both psychological intervention and GnRH-a treatment.All patients received continuous treatment for a duration of 6 months.The general clinical data,positive rate of immune function indexes(including AEmAb,AsAb,and AZpAb),and negative emotions(measured by the HAMA score and HAMD scores)changes in sex hormone(LH,FSH,and E2),and serum inflammatory factors(IL-2,IL-6,CRP,and TNF-α)were compared before and after treatment in both groups.Finally,the recurrence rates of the disease in both groups were compared.Results The positive rates of AEmAb,AsAb,AZpAb,and E2 significantly decreased after intervention in both groups,whereas FSH and LH significantly increased compared to before intervention(P<0.05).However,there were no significant variations in immune function and sex hormone(P>0.05).Following intervention,the average HAMA,HAMD score,serum TNF-αand IL-6 were significantly lower in the combined psychological intervention group compared to the pre-intervention and GnRH-an intervention group(P<0.05).The recurrence rate of the combined psychological intervention group was lower,although there were no significant differences(P>0.05).Conclusion For patients with ovarian endometriosis after laparoscopic surgery,combined application of GnRH-a and psychological intervention could significantly improve patients negative emotion,autoimmune status,sex hormo

关 键 词：卵巢子宫内膜异位症 心理干预 促性腺激素释放激素 

分 类 号：R711.71[医药卫生—妇产科学]