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| Correlation between the changes of blood coagulation function and inflammatory factors of patients with stage Ⅲ/Ⅳ endometriosis and their pelvic pain and adhesions |
| 1. Jingning People's Hospital, Lishui, Zhejiang Province, 323500; 2. Lishui Central Hospital of Zhejiang Province |
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Abstract To observe the changes of coagulation index and inflammatory factors of patients with stage Ⅲ/Ⅳ endometriosis (EMs), and to analyze the correlation between the changes of blood coagulation function and inflammatory factors of patients with EMs and their pelvic pain and adhesion. Methods: From March 2020 to August 2021, 207 patients with stage III/IV EMs were collected and were divided into group A1 (132 patients with stage III EMs) and group A2 (75 patients with stage IV EMs) according to the modified endometriosis staging method (r-AFS). These patients were divided into group B1 (28 patients without pain), group B2 (121 patients with mild to moderate pain), and group B3 (58 patients with severe pain) according to the degree of pain of the patients. And these patients were also divided into group C1 (25 patients without pelvic adhesion), group C2 (138 patients with mild to moderate pelvic adhesion), and group C3 (44 patients with severe pelvic adhesion) according to the pelvic adhesion situation. Another 200 healthy women were selected in control group during the same period. The coagulation function indexes and inflammatory factor levels of the patients were detected and were compared among these groups. The relationship between the coagulation function indexes and inflammatory factor levels of the patients and their degree of EMs-related pain and adhesion were analyzed. Results: The values of thrombin time (PT), activated partial thrombin time (APTT), and prothrombin time (TT) of the patients with Ems were significantly shorter than those of the patients in the control group, and the levels of fibrinogen (FIB), D-dimer (D-D), neutrophil to lymphocyte count ratio (NLR), monocyte chemokine factor-1 (McP-1), tumor necrosis factor -α (TNF-α), interleukin (IL) -6, and IL-8 of the patients with Ems were significantly higher than those of the patients in the control group (all P＜0.05). The levels of FIB, D-D, NLR, McP-1, TNF-α, IL-6, and IL-8 of the patients in group A2 were significantly higher than those of the patients in group A1 (P＜0.05). There were no significant differences in the values of coagulation function indexes among patients with different pelvic pain degree (P＞0.05), but the levels of NLR, McP-1, TNF-α, IL-6, and IL-8 of the patients with Ems had increased with the severity of their pelvic pain. The PT value of the patients with Ems had decreased with the increase of their pelvic adhesion, while the levels of FIB, D-D, NLR, McP-1, TNF-α, IL-6, and IL-8 of the patients with Ems had increased with the increase of their pelvic adhesion (all P＜0.05). The PT value of the patients with Ems was negatively correlated with their degree of pelvic adhesion, while the levels of FIB, D-D, NLR, McP-1, TNF-α, IL-6, and IL-8 of the patients with Ems were positively correlated with their degree of pelvic pain and adhesion (all P＜0.05). Conclusion: The patients with stage III/IV EMs have different degrees of hypercoagulability of blood and inflammatory response. The coagulation function indexes and inflammatory factors levels of the patients with stage III/IV EMs are related to their degree of pelvic adhesion, and the inflammatory factors of the patients are also closely related to their EMs-related pelvic pain.
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