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[1]桑佳特,杜 雪.子宫腺肌病患者外周血、衍生参数及凝血功能的临床分析[J].天津医科大学学报,2024,30(01):74-78.[doi:10.20135/j.issn.1006-8147.2024.01.0074]
 SANG Jiate,DU Xue.Clinical evaluation of peripheral blood cells, derived parameters, and coagulation function in adenomyosis patients[J].Journal of Tianjin Medical University,2024,30(01):74-78.[doi:10.20135/j.issn.1006-8147.2024.01.0074]
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子宫腺肌病患者外周血、衍生参数及凝血功能的临床分析(PDF)
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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:
30卷
期数:
2024年01期
页码:
74-78
栏目:
临床医学
出版日期:
2024-01-01

文章信息/Info

Title:
Clinical evaluation of peripheral blood cells, derived parameters, and coagulation function in adenomyosis patients
文章编号:
1006-8147(2024)01-0074-05
作者:
桑佳特杜 雪
(天津市人民医院妇科,天津300121)
Author(s):
SANG Jiate DU Xue
(Department of Gynecology,Tianjin Union Medical Center,Tianjin 300121,China )
关键词:
子宫腺肌病凝血功能CA125子宫体积贫血
Keywords:
adenomyosiscoagulation functionCA125uterine volumeanemia
分类号:
R71
DOI:
10.20135/j.issn.1006-8147.2024.01.0074
文献标志码:
A
摘要:
目的:初步探讨子宫腺肌病患者外周血血细胞及其衍生参数和凝血功能的改变, 研究其对子宫腺肌病的临床意义和诊断价值。方法:回顾性分析2018年9月—2023年8月于天津市人民医院妇科住院治疗的子宫腺肌病患者(除外子宫肌瘤和子宫内膜异位症)26例。将同期良性卵巢囊肿或子宫内膜单纯性增生的患者(33例)作为对照组,比较两组的临床资料、外周血血细胞、系统性免疫性炎症指数(SII)、全系统性炎症反应指数(SIRI)、凝血功能及血清糖类抗原125(CA125)水平,分析其在子宫腺肌病中的临床意义。结果:与对照组相比,子宫腺肌病组子宫体积增大(Z=-5.746,P<0.01), PLR、 SII、 CA125水平升高(Z=-2.351、 -3.810、-4.805,均P<0.01)。凝血功能方面,凝血酶时间在子宫腺肌病组中明显缩短(Z=-1.971,P<0.05)。子宫腺肌病非出血期组与对照组非出血组间的纤维蛋白原差异具有统计学意义(Z=-1.969,P<0.05)。子宫腺肌病非出血贫血组与对照组非出血贫血组相比,活化部分凝血酶原时间延长(Z=-2.200,P<0.05)。相关性分析发现,子宫腺肌病血红蛋白与凝血酶时间呈正相关(r=0.466,P=0.016)。绘制受试者工作特征曲线后,CA125、PLR和SII的曲线下面积分别为0.883、0.665、0.644。结论:子宫腺肌病患者存在凝血功能异常,CA125对子宫腺肌病有较高的诊断价值,PLR、SII对子宫腺肌病的诊断也有一定的准确性。
Abstract:
Objective: To explore the changes in peripheral blood cells, derived parameters, and coagulation function in adeno-myosis patients, and to investigate their clinical significance and diagnostic value for adenomyosis. Methods: A total of 26 patients with adenomyosis(excluding uterine fibroids and endometriosis) who were hospitalized in the Department of Gynecology of Tianjin Union Medical Center from September 2018 to August 2023 were retrospectively conducted. A total of 33 patients with benign ovarian cysts or simple endometrial hyperplasia during the same period were selected as the control group. The clinical data, peripheral blood cells, systemic immune inflammatory index(SII), systemic inflammatory response index(SIRI), coagulation function, and serum carbohydrate antigen 125(CA125) levels were compared between the two groups, and their clinical significance in adenomyosis was analyzed. Results: Compared with the control group, the uterine volume in the adenomyosis group increased (Z=-5.746, P<0.01), and the levels of PLR, SII, and CA125 increased (Z=-2.351, -3.810, -4.805, all P<0.01). In terms of coagulation function, thrombin time was significantly shortened in the adenomyosis group(Z=-1.971, P<0.05). There was a statistically significant difference in fibrinogen between the non-bleeding stage group of adenomyosis and the control group(Z=-1.969, P<0.05). Compared with the control group, the non-bleeding anemia group with adenomyosis of the uterus showed a longer activated partial prothrombin time(Z=-2.200, P<0.05). Correlation analysis found a positive correlation between hemoglobin and thrombin time in adenomyosis(r=0.466, P=0.016). After drawing the receiver operating characteristic curves of the subjects, the areas under the curves for CA125, PLR, and SII were 0.883, 0.665, and 0.644, respectively. Conclusion: Patients with adenomyosis have abnormal coagulation function, and CA125 has a high diagnostic value for adenomyosis. PLR and SII also have certain accuracy in the diagnosis of adenomyosis.

参考文献/References:

[1] SCHRAGER S,YOGENDRA N, MARQUEZ C M,et al. Adenomyosis: diagnosis and management[J]. Am Fam Physician,2002, 105(1):33-38.
[2] STRUBLE J, REID S, BEDAIWY M A. Adenomyosis: a clinical review of a challenging gynecologic condition[J]. J Minim Invasive Gynecol,2016,23(2): 164-185.
[3] 张会媛,王安琪,王霞,等. 子宫腺肌病发生血栓性病变的风险及临床特点[J]. 国际妇产科学杂志, 2022,49(3):250-255.
[4] YAMANAKA A, KIMURA F, YOSHIDA T. Dysfunctional coagulation and fibrinolysis systems due to adenomyosis is a possible cause of thrombosis and menorrhagia[J]. Eur J Obstet Gynecol Reprod Biol,2016, 204:99-103.
[5] CERNOGORAZ A, SCHIRALDI L, BONAZZA D,et al. Menstruation-related disseminated intravascular coagulation in an adenomyosis patient:case report and review of the literature[J]. Gynecol Endocrinol, 2019,35(1):32-35.
[6] 徐凡,郭方圆,何燕,等. 子宫腺肌病患者外周血血细胞及凝血功能的临床分析[J]. 昆明医科大学学报, 2021,42(11) :128-133.
[7] DING D,LIU X S,DUAN J. Platelets are an unindicted culprit in the development of endometriosis:clinical and experimental evidence[J]. Hum Reprod,30(4): 812-832.
[8] 张会媛,王安琪,朱姝,等. 子宫腺肌病患者凝血功能的变化[J].中华妇产科, 2022,57(3):179-189.
[9] 张德玉,彭超,周应芳,等. 子宫腺肌病患者凝血功能的改变及其临床意义[J]. 中华妇产科, 2022,55(11): 749-753.
[10] LIU X, SHEN M, QI Q, et al. Corroborating evidence for platelet-induced epithelial-mesenchymal transition and fibroblast-to-myofibroblast transdifferentiation in the development of adenomyosis[J].Hum Reprod,2016, 31:734-749.
[11] DU Y,LIU X,GUO S W. Platelets impair natural killer cell reactivity and function in endometriosis through multiple mechanisms[J].Hum Reprod,2017,32:794-810.
[12] QI Q, LIU X, ZHANG Q, et al. Platelets induce increased estrogen production through NF-κB and TGF-β1 signaling pathways in endometriotic stromal cells[J]. Sci Rep,2020,10:1281-2020.
[13] ZHANG Q, DUAN J, LIU X, et al. Platelets drive smooth muscle metaplasia and fibrogenesis in endometriosis through epithelial-mesenchymal transition and fibroblast-to-myofibroblast transdifferentiation[J]. Mol Cell Endocrinol,2016,428: 1-16.
[14] BODUR S, G?譈N I, ALPASLAN BABAYIGI T M. The significance of mean platelet volume on diagnosis and management of adenomyosis[J]. Med Glas,2013,10: 59-62.
[15] MOSELE S, STRATOPOULOU C A, CAMBONI A, et al. Investigation of the role of platelets in the aetiopathogenesis of adenomyosis[J]. Reprod Biomed Online,2021,21:826-834.
[16] COSKUN B, INCE O, ERKILINC S, et al. The feasibility of the platelet count and mean platelet volume as markers of endometriosis and adenomyosis: a case control study[J]. Obstet Hum Reprod,2019, 49:101626.
[17] HONG E Y, LIN H Z,FONG Y F. Venous thromboembolism and adenomyosis: a retrospective review[J]. Gynecol Minim Invasive Ther,2020,9(2): 64-68.
[18] LIN Q, LI T, DING S, et al. Anemia-associated platelets and plasma prothrombin time increase in patients with adenomyosis[J]. J Clin Med,2022,15(11):4382.
[19] ASO Y,CHIKAZAWA R, KIM URA Y,et al. Recurrent multiple cerebral infarctions related to the progression of adenomyosis: a case report[J]. BMC Neurol, 2018,18(1):119.
[20] BYRNES J R, WOLBERG A S. Red blood cells in thrombosis[J].Blood, 2017,130:1795-1799.
[21] ROELOFFZEN W W, KLUIN-NELEMANS H C, BOSMAN L, et al. Effects of red blood cells on hemostasis[J]. Transfusion,2010, 50: 1536-1544.
[22] FAES C, ILICH A, SOTIAUX A, et al. Red blood cells modulate structure and dynamics of venous clot formation in sickle cell disease[J]. Blood, 2019,133(23):2529-2541.
[23] TANG X, FANG M, CHENG R, et al. Iron-deficiency and estrogen are associated with ischemic stroke by up-regulating transferrin to induce hypercoagulability[J]. Circ Res,2020,127:651-663.
[24] KLATT C, KR?譈GER I, ZEY S, et al. Platelet-RBC interaction mediated by FasL/FasR induces procoagulant activity important for thrombosis[J]. J Clin Investig,2018,128: 3906-3925.
[25] YAMASHIRO K, TANAKA R, NISHIOKA K, et al. Cerebral infarcts associated with adenomyosis among middle-aged women[J]. J Stroke Cerebrovasc,2012,21:910.e1-e5.
[26] YOO H J, CHANG D S, LEE K H. Acute renal failure induced by disseminated intravascular coagulopathy in a patient with adenomyosis[J]. J Obstet Gynaecol,2012,38:593-596.
[27] NAKAMURA Y, KAWAMURA N, ISHIKO O, et al. Acute disseminated intravascular coagulation developed during menstruation in an adenomyosis patient[J]. Arch Gynecol Obstet,2002,267:110-112.
[28] ZHOU Q,ZHU C,SHEN Z. Incidence and potential predictors of thromboembolic events in epithelial ovarian carcinoma patients during perioperative period[J]. Eur J Surg Oncol, 2020,46(5):855-861.
[29] SHAO B, WAHRENBROCK M G, YAO L, et al. Carcinoma mucins trigger reciprocal activation of platelets and neutrophils in a murine model of Trousseau syndrome[J]. Blood, 2011,118:4015-4023.
[30] WAHRENBROCK M, BORSIG L, LE D, et al. Selectin-mucin interactions as a probable molecular explanation for the association of Trousseau syndrome with mucinous adenocarcinomas[J]. Clin Investig,2002,112:853-862.
[31] ZHAI J,VANNUCCINI S,PETRAGLI A F. Adenomyosis: mechanisms and pathogenesis[J]. Semin Reprod Med, 2020,38:129-143.

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备注/Memo

备注/Memo:
作者简介 桑佳特(1987-),女,医师,硕士,研究方向:子宫肌腺病的临床与基础;通信作者:杜雪,E-mail:lanlandetommao@163.com。
更新日期/Last Update: 2024-01-01