子宫腺肌病痛经相关的炎性介质及相关临床特征分析

发布时间：2018-01-19 13:30

本文关键词： 子宫腺肌病痛经 PLA2 PGF2a LI-6　出处：《福建医科大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的:探讨子宫腺肌病中痛经与炎性介质的关系及相关临床特点。方法:选择福建中医药大学附属人民医院2011年10月～2012年10月因子宫腺肌病住院拟行腹腔镜子宫切除的病例100例，所有患者均采用腹腔镜手术治疗，其中腹腔镜全子宫切除54例，腹腔镜次全子宫切除46例，并经术后病理确诊。根据患者术前痛经程度分4组，，无痛经组、轻度痛经组、中度痛经组、重度痛经组。以同期无痛经症状的子宫肌瘤住院行手术治疗病例100例为对照组。分析痛经与子宫大小、血清CA125、IL-6，腹腔液测定PGF2a及sPLA2值的关系。对手术方式及术后1-6月恢复情况进行随访和回顾分析。结果：1、子宫腺肌病组平均年龄较子宫肌瘤组提前6年。 2、血清CA125值在子宫腺肌病（AM）组（125.62±20.34U/ml），明显高于对照组（15.91±11.52U/ml）(P0.05)，并与子宫大小呈正相关(P0.05)。白介素6（IL-6）、腹腔液前列腺素（PGF2a）、磷脂酶A2（sPLA2）在AM组（52.23±4.93pg/ml，83.43±5.93ρ/pg mg-1,76.34±5.34u/L,)高于对照组(15.23±6.07pg/ml，33.64±5.95,34ρ/pg mg-1,42±11.32u/L)(P0.05)，与痛经程度正相关(P0.05)。 3、子宫切除手术均能满意缓解近期痛经症状，但次全子宫切除较行全子宫切除更有利于术后恢复。结论：1.子宫腺肌症疼痛程度与机体内源性炎症因子IL-6、PLA2、PGF2a有关。 2．痛经是患者行手术治疗的主要原因，子宫切除手术对缓解近期疼痛症状有效。
[Abstract]:Objective: to investigate the relationship between dysmenorrhea and inflammatory mediators in adenomyosis. A total of 100 patients with adenomyosis were selected from the people's Hospital of Fujian University of traditional Chinese Medicine from October 2011 to October 2012. All patients were treated by laparoscopic hysterectomy 54 cases laparoscopic subtotal hysterectomy 46 cases confirmed by postoperative pathology. According to the degree of preoperative dysmenorrhea patients were divided into 4 groups without dysmenorrhea group. Mild dysmenorrhea group, moderate dysmenorrhea group, severe dysmenorrhea group. 100 cases of myoma without dysmenorrhea were treated by operation in the same period as control group. The size of dysmenorrhea and uterus, serum CA125 were analyzed. The relationship between IL-6 and PGF2a and sPLA2 in peritoneal fluid was analyzed retrospectively. The operative method and the recovery from 1 to 6 months after operation were followed up and analyzed retrospectively. Results the average age of adenomyosis group was 6 years earlier than that of hysteromyoma group. 2Serum CA125 level was 125.62 卤20.34 U / ml in adenomyosis group. It was significantly higher than that in the control group (15.91 卤11.52 U / ml, P 0.05, P 0.05), and was positively correlated with the size of uterus. Interleukin-6, prostaglandin PGF2a, phospholipase A2sPLA2) was 52.23 卤4.93 PG / ml in AM group. 83.43 卤5.93 蟻 / PG mg-1a 76.34 卤5.34 u / L) was higher than that of the control group (15.23 卤6.07pg / ml, 33.64 卤5.95). 34 蟻 / PG mg ~ (-1) 42 卤11.32 u 路L ~ (-1) P _ (0.05), which was positively correlated with the degree of dysmenorrhea. 3. Hysterectomy can relieve the symptoms of dysmenorrhea, but subtotal hysterectomy is more beneficial to postoperative recovery than total hysterectomy. Conclusion 1. The degree of pain in adenomyosis is related to the endogenous inflammatory factor IL-6, PLA2 and PGF2a. 2. Dysmenorrhea is the main cause of surgical treatment. Hysterectomy is effective in relieving recent pain symptoms.
【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R711.71

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