己酮可可碱辅助治疗对子宫内膜异位症患者血液流变学指标和炎症因子水平的影响

Effect of pentoxifylline as an adjuvant therapy on hemorheological parameters and levels of inflammatory factors in patients with endometriosis

摘要:

目的 探讨己酮可可碱辅助治疗对子宫内膜异位症患者血液流变学指标和炎症因子水平的影响。方法 选取2020年2月—2023年2月西北妇女儿童医院收治的96例子宫内膜异位症患者，依据随机数字表法分为对照组和实验组，每组48例。对照组接受炔雌醇环丙孕酮片治疗，实验组在此基础上结合己酮可可碱治疗。比较两组患者血液流变学指标、炎症因子、血管内皮功能、糖类抗原125（CA-125）水平、月经失血图（PBAC）评分、痛经症状（CMSS）评分、盆腔症状主观感受评分、不良反应（阴道不适、潮热、消化道反应、胸痛）和复发率的差异。结果 实验组治疗前后血浆黏度、纤维蛋白原水平和红细胞聚集指数的差值均高于对照组（P <0.05）。实验组治疗前后肿瘤坏死因子-α、干扰素-γ、白细胞介素-2、白细胞介素-1β的差值均高于对照组（P <0.05）。实验组治疗前后血管内皮生长因子、血清内皮素-1和一氧化氮的差值均高于对照组（P <0.05），CA-125的差值低于对照组（P <0.05）。实验组治疗前后PBAC评分、CMSS评分和盆腔症状主观感受评分的差值均高于对照组（P <0.05）。两组患者不良反应总发生率和复发率比较，差异均无统计学意义（P >0.05）。结论 己酮可可碱辅助治疗能有效改善子宫内膜异位症患者的血液流变学指标和炎症因子水平，提升血管内皮功能，并改善月经失血量和痛经症状，同时证实了其安全性和有效性。

Abstract:

Objective To investigate the effects of pentoxifylline as an adjuvant therapy on hemorheological parameters and levels of inflammatory factors in patients with endometriosis.Methods This study recruited 96 patients with endometriosis treated at Northwest Women and Children's Hospital from February 2020 to February 2023. They were randomly divided into a control group and an experimental group, with 48 patients in each. The control group received treatment with ethinylestradiol and cyproterone acetate tablets, while the experimental group additionally received pentoxifylline in addition to the standard therapy. The differences between the two groups were compared in terms of hemorheological parameters, inflammatory factors, vascular endothelial function, levels of carbohydrate antigen 125 (CA-125), Pictorial Blood Assessment Chart (PBAC) scores, Cox Menstrual Symptom Scale (CMSS) scores, subjective pelvic symptom scores, adverse reactions (vaginal discomfort, hot flashes, gastrointestinal reactions, and chest pain), and recurrence rates.Results The differences in plasma viscosity, fibrinogen levels, and red blood cell aggregation index before and after treatment were higher in the experimental group than in the control group (P < 0.05). The differences in levels of tumor necrosis factor-α, interferon-γ, interleukin-2, and interleukin-1β before and after treatment were higher in the experimental group than in the control group (P < 0.05). The differences in levels of vascular endothelial growth factor, serum endothelin-1, and nitric oxide before and after treatment were higher in the experimental group than in the control group (P < 0.05). The differences in PBAC, CMSS, and subjective pelvic symptom scores before and after treatment were also higher in the experimental group than in the control group (P < 0.05). There was no significant difference in the overall incidence of adverse reactions and recurrence rates between the two groups (P > 0.05).Conclusion Pentoxifylline as an adjuvant therapy can effectively improve hemorheological parameters and levels of inflammatory factors, enhance vascular endothelial function, and alleviate menstrual blood loss and dysmenorrhea symptoms in patients with endometriosis. This study confirms both its safety and efficacy.