HIFU联合GnRHa治疗子宫腺肌病后患者血清CA125、MMP-3水平变化及与痛经程度关系  

Changes of the serum carbohydrate antigen 125 and matrix metalloproteinase levels of patients with adenomyosis after the high intensity focused ultrasound(HIFU)combined with gonadotropin releasing hormone agonist treatment and their correlation with the

作　　者：王纯 胡春峰 李明 WANG Chun;HU Chunfeng;LI Ming(The Affiliated Huaian Hospital of Xuzhou Medical University/Huaian Second People's Hospital,Huaian,Jiangsu Province,223001;The Affiliated Hospital of Xuzhou Medical University,Xuzhou)

机构地区：[1]徐州医科大学附属淮安医院,淮安市第二人民医院,223001 [2]徐州医科大学附属医院

出　　处：《中国计划生育学杂志》2025年第2期274-279,共6页Chinese Journal of Family Planning

摘　　要：目的:探讨子宫腺肌病(AM)患者经高强度聚焦超声(HIFU)联合促性腺激素释放激素激动剂(GnRHa)治疗后血清糖类抗原125(CA125)、基质金属蛋白酶(MMP-3)水平变化及与痛经严重程度关系。方法:前瞻性选取2022年1月-2024年1月本院收治的行HIFU联合GnRHa治疗的AM患者100例作为研究对象,于治疗前、治疗后3个月、6个月时测定AM患者血清CA125、MMP-3水平,同时评估患者痛经严重程度[视觉模拟量表(VAS)评分];采用双变量皮尔逊(N)分析血清CA125、MMP-3水平变化与AM患者痛经严重程度的相关性。根据治疗前患者的痛经严重程度分为轻度组48例、中度组33例、重度组19例,比较3组临床基线资料及血清CA125、MMP-3水平;有序logistic回归分析AM患者痛经严重程度的影响因素。结果:治疗后3、6个月时血清CA125(65.57±5.64U/ml、43.51±4.58U/ml)、MMP-3水平(19.47±5.86ng/ml、14.06±4.38ng/ml)及VAS评分(2.27±0.59分、1.31±0.43分)与治疗前(72.99±6.44 U/ml、43.60±5.76 ng/ml、7.10±1.26分)比较依次降低;双变量皮尔逊(N)分析显示,血清CA125、MMP-3水平与VAS评分呈正相关;轻度组、中度组、重度组病灶体积、孕次、血清CA125及MMP-3水平依次升高;logistic回归分析显示,病灶体积增加、孕次增多及血清CA125升高、MMP-3升高是影响AM患者痛经程度的独立因素(均P<0.05)。结论:AM患者HIFU联合GnRHa治疗可改善血清CA125、MMP-3水平,缓解痛经;同时血清CA125、MMP-3水平与患者疼痛程度正相关相关,病灶体积增加、孕次增多、血清CA125升高、MMP-3升高是AM患者痛经严重程度的影响因素。Objective:To investigate the changes of the levels of serum carbohydrate antigen 125(CA125)and matrix metalloproteinase(MMP-3)of patients with adenomyosis(AM)after the high intensity focused ultrasound(HIFU)combined with gonadotropin releasing hormone agonist(GnRHa)treatment,and to study their correlation with the dysmenorrhea severity of the patients.Methods:A prospective study was conducted to select 100 patients with AM who were treated with HIFU combined with GnRHa in the hospital from January 2022 to January 2024 as the research objects.The serum CA125 and MMP-3 levels of the patients were measured before treatment,and in the 3rd month and in the 6th month after treatment.The severity of dysmenorrhea of the patients was evaluated by visual analogue scale(VAS)score.The correlation between the changes of the serum CA125 and MMP-3 levels of the patients and the severity of their dysmenorrhea was analyzed by bivariate Pearson(N).According to the severity of dysmenorrhea of the patients before treatment,these patients were divided into group A(48cases with mild dysmenorrhea),group B(33cases with moderate dysmenorrhea)and group C(19cases with severe dysmenorrhea).The clinical baseline data and the serum CA125and MMP-3levels of the patients were compared among the three groups.The influencing factors of the dysmenorrhea severity of the patients were analyzed by ordinal logistic regression.Results:The levels of serum CA125and MMP-3and the VAS score of the patients before treatment(72.99±6.44U/ml,43.60±5.76ng/ml and 7.10±1.26points),in the 3rd month after treatment(65.57±5.64U/ml,19.47±5.86ng/ml and 2.27and 2.27±0.59points),and in the 6th month after treatment(43.51±4.58U/ml,14.06±4.38ng/ml and 1.31±0.43points)had decreased gradually.Bivariate Pearson(N)analysis showed that the serum CA125and MMP-3levels of the patients were positively correlated with their VAS score of dysmenorrhea.The lesion volume,the gravidity and the serum CA125and MMP-3levels of the patients in group A,in group B and in group C had inc

关 键 词：子宫腺肌病 高强度聚焦超声 促性腺激素释放激素激动剂 痛经 糖类抗原125 基质金属蛋白酶 影响因素 

分 类 号：R711.71[医药卫生—妇产科学]