[Role and clinical significance of coagulation and inflammatory factors in moderate and severe ovarian endometriosis].

凝血和炎症因子在中重度卵巢子宫内膜异位症发病中的作用及临床诊断的意义 Role and clinical significance of coagulation and inflammatory factors in moderate and severe ovarian endometriosis 摘要目的 通过测定中重度卵巢子宫内膜异位症(内异症)患者的凝血与炎症因子水平,探讨凝血与炎症因子在卵巢内异症发病中的作用及临床诊断的意义.方法 回顾性分析2015年6月—2017年6月在浙江大学医学院附属妇产科医院住院手术并经病理检查证实为中重度卵巢内异症的366例患者(内异症组)和病理检查证实为卵巢良性囊肿的244例患者(非内异症组)的临床资料,比较两组患者的凝血和炎症因子水平以及血清CA125水平[其结果均呈偏态分布,故以M(P25~P75)表示];并分析凝血和炎症因子以及血清CA125水平在中重度卵巢内异症诊断中的价值.结果(1)内异症组患者的血浆凝血酶原时间(PT)和凝血酶时间(TT)分别为12.8 s(12.4~13.2 s)和15.5 s(15.1~15.9 s),均明显短于非内异症组[分别为13.0 s(12.5~13.4 s)和15.7 s(15.3~16.1 s);P均<0.01];血浆纤维蛋白原(FIB)和D-二聚体(D-D)分别为3.1 g/L(2.8~3.5 g/L)和0.9 mg/L(0.6~2.1 mg/L),均明显高于非内异症组[分别为2.8 g/L(2.6~3.2 g/L)和0.6 mg/L(0.4~1.2 mg/L);P均=0.000];嗜中性粒细胞数/淋巴细胞数的比值(NLR)和血小板计数(PLT)/淋巴细胞数的比值(PLR)分别为2.3(1.8~3.1)和144(113~179),均明显高于非内异症组[分别为2.1(1.6~2.8)和128(104~165);P均<0.01].Ⅳ期内异症患者的PT明显短于Ⅲ期内异症者(P<0.05),Ⅳ期内异症患者的FIB、PLT和PLR均显著高于Ⅲ期内异症者(P均<0.01).(2)血清CA125水平诊断中重度内异症的最佳诊断界值为27.2 kU/L,敏感度为83.6%;FIB的最佳诊断界值为3.1 g/L,敏感度为53.2%;联合指标(即FIB×CA125)的敏感度为84.9%.结论凝血与炎症因子异常可能与中重度卵巢内异症的发病有关,检测凝血与炎症因子可能对于中重度卵巢内异症的临床诊治具有重要意义. 更多相关知识 abstractsObjective To determine the levels of coagulation and inflammatory factors in women with moderate and severe ovarian endometriosis so as to investigate the possible role of coagulation and inflammatory factors in the pathogenesis, diagnosis and treatment of this disease. Methods From June 2015 and June 2017,clinical data of 366 patients with pathologically diagnosed moderate and severe ovarian endometriosis (case group) and 244 patients with pathologically diagnosed benign ovarian cysts (control group)in Women′s Hospital of Zhejiang University School of Medicine were retrospectively analyzed.The levels of coagulation indicators, inflammatory factors and serum tumor markers were measured. Then, the values of these indicators in diagnosis of endometriosis were analyzed. Results(1)The levels of plasma prothrombin time(PT)and thrombin time(TT)in patients with ovarian endometriosis [median: 12.8 s (range:12.4-13.2 s)and 15.5 s(range:15.1-15.9 s),respectively]were significantly shorter than those with benign ovarian cysts[median:13.0 s(range:12.5-13.4 s)and 15.7 s(range:15.3-16.1 s),respectively;all P<0.01].The levels of plasma fibrinogen(FIB)and D-dimer[D-D;median:3.1 g/L(range:2.8-3.5 g/L)and 0.9 mg/L(range:0.6-2.1 mg/L),respectively]in patients with ovarian endometriosis were significantly higher than those with benign ovarian cysts[median:2.8 g/L(range:2.6-3.2 g/L)and 0.6 mg/L(range:0.4-1.2 mg/L), respectively; P=0.000]. Moreover, neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio [PLR; median: 2.3 (range: 1.8-3.1) and 144 (range: 113-179), respectively] in patients with ovarian endometriosis were significantly higher than those with benign ovarian cysts [median: 2.1 (range: 1.6-2.8) and 128 (range: 104-165), respectively; P<0.01]. Furthermore, in patients with ovarian endometriosis, the levels of PT were significantly shorter in stage Ⅳ endometriosis than that in stage Ⅲ endometriosis (P<0.05).The levels of FIB and PLR in patients with stageⅣendometriosis were significantly higher than those in patients with stage Ⅲ endometriosis(P<0.01).(2)The cut-off value of CA125was 27.2 kU/L with a sensitivity of 83.6%,the cut-off value of FIB was 3.1 g/L with a sensitivity of 53.2%,while the sensitivity of combination index(FIB×CA125)was 84.9%.Conclusion The abnormality of coagulation and inflammatory factors may be involved in the pathogenesis of moderate and severe ovarian endometriosis,and the detection of coagulation and inflammatory factors may be have important clinical significance for the diagnosis and treatment of moderate and severe ovarian endometriosis. More相关知识 - 浏览666 - 被引69 - 下载542 相似文献 - 中文期刊 - 外文期刊 - 学位论文 - 会议论文