纠正子宫腺肌症免疫紊乱的新方法

M. Scherbina, Lilya Potapova, I. Scherbina, Olga Mertsalova, A. Chekhunova
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摘要

摘要人们对生殖器子宫内膜异位症问题进行了大量研究,但该病的病因和发病机制仍未得到解决。约有 10% 的育龄妇女患有子宫腺肌症,30% 的盆腔疼痛综合征妇女和高达 50% 的女性不孕症患者患有子宫腺肌症。关于子宫内膜异位症起源的众多理论都无法解释疾病发展的关键点,即子宫内膜基底层穿透邻近的子宫肌层。因此,很难为子宫腺肌症患者选择适当的治疗策略。子宫腺肌症的治疗是现代妇科最棘手的问题之一,而提高子宫腺肌症患者治疗效果的有效方法之一就是免疫纠正疗法。这项工作的目的是在研究病因的基础上,通过改进患者管理的诊断和预后策略,提高子宫腺肌症患者的治疗效果。材料和方法。研究纳入了 115 名育龄期患者。评估了复合疗法与传统疗法相比的疗效。对临床和实验室、仪器和免疫学指标进行了动态评估。研究结果及其讨论。考虑到发病机制的特殊性,即免疫的细胞和巨噬细胞环节受到破坏、细胞因子失衡,这些因素都会导致疾病的发展和持续存在,因此我们制定了一种综合方法来提高子宫腺肌症患者的治疗效果,旨在降低促炎免疫潜能。在综合治疗的背景下,自身免疫反应活动减少,中性粒细胞和单核细胞的吞噬和氧活性指标恢复正常,细胞因子失衡减少--促炎细胞因子和血管内皮生长因子的分泌水平恢复正常。结论根据研究结果,对子宫腺肌症患者的治疗方法进行了优化,证实了在综合疗法中使用纠正药物的可行性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
New approaches to the correction of immune disorders in adenomyosis
ABSTRACT. A large number of studies have been devoted to the study of the problem of genital endometriosis, however, the etiology and mechanisms of the disease remain unresolved. Adenomyosis affects about 10% of women of reproductive age, occurs in 30% of women with pelvic pain syndrome and up to 50% of patients with female infertility. Numerous theories of the origin of endometriosis cannot explain the key points in the development of the disease, namely the penetration of the basal layer of the endometrium into the adjacent myometrium. This makes it difficult to choose an adequate treatment strategy for patients with adenomyosis. Treatment of adenomyosis is one of the most difficult issues in modern gynecology, one of the promising approaches in increasing the effectiveness of treatment of patients with adenomyosis is immunocorrective therapy. The aim of the work was to increase the effectiveness of treatment of adenomyosis patients by improving the diagnostic and prognostic tactics of patient management based on the study of pathogenetic aspects. Materials and methods. 115 patients of reproductive age were included in the study. The effectiveness of complex compared to traditional treatment was evaluated. Clinical and laboratory, instrumental and immunological indicators were evaluated in dynamics. Research results and their discussion. Taking into account the peculiarities of pathogenetic mechanisms, which indicate a violation of the cellular and macrophage links of immunity, cytokine imbalance, which contribute to the development of the disease and its persistence, we have developed a comprehensive approach to increasing the effectiveness of the treatment of patients with adenomyosis, which aims to reduce the pro-inflammatory immunological potential. Against the background of the comprehensive treatment, the activity of autoimmune reactions is reduced, the indicators of phagocytic and oxygen activity of neutrophils and monocytes are normalized, cytokine imbalance is reduced - the level of production of pro-inflammatory cytokines and VEGF is normalized. Conclusions. Based on the results of the work, the approaches to the treatment of adenomyosis patients were optimized, the feasibility of using corrective drugs in complex therapy was substantiated.
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