The Effect Of High-Intensity Focused Ultrasound On Stress And Immune Function To Patients With Uterine Leiomyomas In The Perioperative Period

Objective: To investigate the effect of high-intensity focused ultrasound on stress and immune function to patients with uterine leiomyomas in the perioperative period.Method: 87 patients with uterine leiomyomas who recieved treatment,and were diagnosed by clinical symptoms and imageology in the Affiliated Hospital of North Sichuan Medical College from June to December 2016 were selected as clinical subjects.They were divided into the following groups according to the patients' treatment choices: HIFU treatment(observation group),laparoscopic myomectomy(control group)and conventional myomectomy(control group).There are 38 cases for the HIFU group,29 cases for the laparoscopic myomectomy group and 20 cases for the conventional myomectomy group.The venous blood samples were taken from the patients before the operation and 24 hours after.The percentage of CD4 +,CD8+ T lymphocytes in peripheral blood was measured by flow cytometry(FCM),and calculate the ratio of CD4+/CD8+.The serum levels of interleukin-2(IL-2)and IL-10 were quantified by enzyme-linked immunosorbent assay(ELISA).The white blood cell(WBC)and neutrophil granulocyte ratio(NGR)were determined by Blood cell analyzer.The changes of the detection indexes before and after the operation were compared among the three groups.Results:(1)The differences of CD4+T lymphocytes and the CD4+/CD8+ ratio among these three groups 24 hours after the operation were statistically significant(P<0.05).The percentage of CD4+T lymphocytes and CD4+/CD8+ ratio in the laparoscopic myomectomy group and the conventional myomectomy group were significantly lower than those in the HIFU group,and the differences were statistically significant(P<0.05),But there were no significant differences between the laparoscopic and the conventional myomectomy groups(P>0.05).There were no significant differences in the percentage of CD8+ T cells among these three groups(P>0.05).In each group,the percentage of CD4+,CD8+ T lymphocytes and CD4+/CD8+ ratio in the laparoscopic and the conventional myomectomy groups were lower than those before the operation,and the differences were statistically significant(P<0.05).However,those detection indexes in the HIFU group had no significant differences compared with those before the operation(P>0.05).(2)The differences of plasma IL-2 and IL-10 in these three groups were statistically significant(P<0.05)24 hours after the operation.The levels of plasma IL-2 in HIFU group were significantly higher than those in laparoscopic and the conventional myomectomy groups(P<0.05),There were no significant differences between the laparoscopic and the conventional myomectomy groups(P>0.05).The levels of plasma IL-10 in the conventional myomectomy group were significantly higher than those in the HIFU group and the laparoscopic group,the differences were statistically significant(P<0.05),There were no differences between the laparoscopic group and the HIFU group(P>0.05).In each group,the level of IL-2 in the HIFU group was higher than before the operation(P<0.05),but the level of IL-2 in laparoscopic and the conventional myomectomy groups were lower than that before the operation,and the differences were statistically significant(P<0.05).The level of plasma IL-10 in the conventional myomectomy group was higher than before operation,and the difference was statistically significant(P<0.05).However,in the HIFU and the laparoscopic myomectomy group,there were no significant differences in the IL-10 level,compared with before operation(P>0.05).(3)The WBC and NGR in the three groups were different,and the highest in the conventional myomectomy group,the lowest in the HIFU group and the differences were statistically significant(P<0.05).In each group,The WBC and NGR in these three groups were higher than those before the operation.The number in the conventional myomectomy group has increased the most,then followed by the laparoscopic myomectomy group,and the HIFU group has the smallest increase,and the differences were statistically significant(P<0.05).Conclusions:(1)The degree of the body's stress response towards the HIFU treatment is lower than that towards the laparoscopic and conventional myomectomy in the perioperative period,it has small trauma to the body.(2)HIFU treatment for the uterine fibroids maybe can enhance the body's cellular immune function in the perioperative period to a certain degree,and it is a safer minimally invasive treatment.