HOMOCYSTEINE LEVELS IN WOMEN WITH SYMPTOMATIC UTERINE FIBROIDS

Yuliya Dmitrievna Sidorova, Liana Yur'evna Davidyan, Azat Yur'evich Bogdasarov
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Abstract

Uterine fibroids are considered one of the most common benign tumors of the reproductive system. This disease ranks second (20–50 %) among the causes of hospitalization in gynecological hospitals. The aim of the study is to evaluate the effect of homocysteine levels on the state of uterine fibroids. Materials and Methods. The study involved 112 women: 60 with uterine fibroids and 52 without uterine fibroids. General clinical, biochemical, ultrasound, and statistical research methods were used. Mathematical data processing was carried out according to Lang T. and Altman D. (2014). Quantitative data analysis on the normality of distribution was carried out using the Shapiro-Wilk test. Results. The normal homocysteine (Hc) level was found in 80.7 (5.5) % of patients without uterine fibroids, which is statistically more significant than in the group of women with uterine myoma (38.3 (6.3) %, p<0.001). HC level was at the upper normal level in 33.3 (6.1) % of women in the main group and 15.3 (5.0) % of women in the comparison group. An excess of normal values was found in 25.0 (5.6) % of women in the main group and only in one in the comparison group (p<0.001). Due to additional therapy of uterine fibroids, the state of myomatous nodes stabilized in 61.6 (6.3) % of patients. There was no progression of uterine fibroids during a year. Before complex therapy, surgical indications were in 25.0 (5.6) % of patients with uterine fibroids. After a year of complex therapy, surgical indications remained only in 6.6 (3.3) % of women with uterine fibroids, which is statistically less significant than before the prescribed treatment (p=0.005). Conclusion. In women with uterine fibroids, there are multiple genital and somatic pathologies that contribute to the increase of Hc level and the development of uterine fibroids. The use of folic acid and B-group vitamins in addition to the clinical protocol for the treatment of uterine fibroids made it possible to stabilize the myomatous nodes and reduce surgical treatment by 4 times.
有症状的子宫肌瘤妇女的同型半胱氨酸水平
子宫肌瘤被认为是生殖系统最常见的良性肿瘤之一。这种疾病在妇科医院住院的原因中排名第二(20 - 50%)。本研究的目的是评价同型半胱氨酸水平对子宫肌瘤状态的影响。材料与方法。这项研究涉及112名妇女:60名有子宫肌瘤,52名没有子宫肌瘤。采用一般临床、生化、超声、统计学等研究方法。根据Lang T. and Altman D.(2014)对数学数据进行处理。采用Shapiro-Wilk检验对分布正态性进行定量数据分析。结果。同型半胱氨酸(Hc)水平正常的子宫肌瘤患者为80.7(5.5)%,明显高于子宫肌瘤患者(38.3 (6.3)%,p<0.001)。主组33.3%(6.1)%的妇女HC水平高于正常水平,对照组15.3%(5.0)%。在主组中,25.0%(5.6%)的妇女发现正常值超过正常值,而在对照组中,只有1名妇女发现正常值超过正常值(p<0.001)。由于子宫肌瘤的附加治疗,61.6(6.3)%的患者肌瘤淋巴结状态稳定。子宫肌瘤一年无进展。综合治疗前,25.0(5.6%)的子宫肌瘤患者有手术指征。经过一年的综合治疗,只有6.6(3.3)%的子宫肌瘤患者的手术指征仍然存在,这与常规治疗前相比,统计学意义上不显著(p=0.005)。结论。在子宫肌瘤患者中,存在多种生殖和躯体病变,可导致Hc水平升高和子宫肌瘤的发生。在治疗子宫肌瘤的临床方案之外,叶酸和b族维生素的使用使肌瘤淋巴结稳定,手术治疗减少了4倍。
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