Zhou Jing, He Li, Liu Ping, Duan Hui, Zhang Hanze, Li Weili, Gong Shipeng, Su Guidong, Chen Chunlin
Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Department of Ophthalmology, School of Medicine, Emory University, Atlanta, Georgia, United States of America.
PLoS One. 2016 Nov 2;11(11):e0165610. doi: 10.1371/journal.pone.0165610. eCollection 2016.
To study the therapeutic effects of uterine artery embolization (UAE) on adenomyosis and to investigate the association between uterine blood supply and artery embolization treatment outcomes.
Using digital subtraction angiography (DSA) imaging data, we retrospectively evaluated the vascular features of 252 adenomyosis patients treated with UAE. The cases were classified based on the equality of uterine blood supply (equal and unequal subgroups) and the degree of vascularity at the adenomyosis lesion site (hypervascular, isovascular and hypovascular subgroups). Patients were followed-up for 5 years after UAE. Improvements in dysmenorrhea and menorrhagia were evaluated based on the relief of the patients' symptoms. The improvement rates among the different subgroups were analyzed and compared.
The improvement rates of dysmenorrhea and menorrhagia were 74.0% and 70.9%, respectively, at the short-term (12-month) follow-up and 70.4% and 68.8%, respectively, at the long-term (5-year) follow-up. No statistically significant differences were observed in the improvement rates for dysmenorrhea or menorrhagia between the equal and unequal blood supply subgroups at either the short- or long-term follow-up. The improvement rates for dysmenorrhea among the hypervascular, isovascular and hypovascular subgroups were 86.5%, 71.8% and 58.8%, respectively, at the short-term follow-up (p = 0.002) and 83.6%, 67.3% and 52.8%, respectively, at the long-term follow-up (p = 0.005). The improvement rates for menorrhagia in the hypervascular, isovascular and hypovascular subgroups were 81.0%, 68.3% and 60.7%, respectively, at the short-term follow-up (p = 0.024) and 79.4%, 61.4% and 62.2%, respectively, at the long-term follow-up (p = 0.052).
UAE is effective in treating patients with adenomyosis in both the short and long term. The outcomes of patients with adenomyosis were significantly correlated with lesion vascularity.
研究子宫动脉栓塞术（UAE）治疗子宫腺肌病的疗效，并探讨子宫血供与动脉栓塞治疗效果之间的关联。
利用数字减影血管造影（DSA）成像数据，我们回顾性评估了252例接受UAE治疗的子宫腺肌病患者的血管特征。病例根据子宫血供的均等性（均等和不均等亚组）以及子宫腺肌病病变部位的血管丰富程度（高血管、等血管和低血管亚组）进行分类。患者在UAE术后随访5年。根据患者症状的缓解情况评估痛经和月经过多的改善情况。分析并比较不同亚组的改善率。
短期（12个月）随访时，痛经和月经过多的改善率分别为74.0%和70.9%，长期（5年）随访时分别为70.4%和68.8%。在短期或长期随访中，均等和不均等血供亚组之间痛经或月经过多的改善率均未观察到统计学上的显著差异。高血管、等血管和低血管亚组在短期随访时痛经的改善率分别为86.5%、71.8%和58.8%（p = 0.002），长期随访时分别为83.6%、67.3%和52.8%（p = 0.005）。高血管、等血管和低血管亚组在短期随访时月经过多的改善率分别为81.0%、68.3%和60.7%（p = 0.024），长期随访时分别为79.4%、61.4%和62.2%（p = 0.052）。
UAE在短期和长期治疗子宫腺肌病患者方面均有效。子宫腺肌病患者的治疗效果与病变血管丰富程度显著相关。
