medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2023-345medsovet-7798Research ArticleРЕПРОДУКТИВНОЕ ЗДОРОВЬЕ И ВРТREPRODUCTIVE HEALTH AND ARTПоказатели качества жизни, тревожно-депрессивной симптоматики и выраженности дисменореи у девочек-подростков с перитонеальным эндометриозом на фоне консервативной терапии в течение годаIndicators of quality of life, anxiety-depressive symptoms and severity of dysmenorrhea in adolescent girls with peritoneal endometriosis during conservative therapy for a yearhttps://orcid.org/0000-0002-3195-307XХащенкоЕ. П.KhashchenkoE. P.

Хащенко Елена Петровна – кандидат медицинских наук, ведущий научный сотрудник 2-го гинекологического отделения (гинекологии детского и юношеского возраста).

117997, Москва, ул. Академика Опарина, д. 4

Elena P. Khashchenko - Cand. Sci. (Med.), Senior Researcher of the 2nd Gynecology of Children and Adolescents Department, Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology.

4, Academician Oparin St., Moscow, 117997

khashchenko_elena@mail.ruАлексееваМ. Н.AlekseevaM. N.

Алексеева Мария Николаевна - студент факультета фундаментальной медицины.

119234, Москва, ул. Колмогорова, д. 1

Maria N. Alekseeva - Student of the Faculty of Fundamental Medicine, Lomonosov Moscow State University.

1, Kolmogorov St., Moscow, 119234

https://orcid.org/0000-0002-3105-5640УвароваЕ. В.UvarovaE. V.

Уварова Елена Витальевна - член-корреспондент РАН, доктор медицинских наук, профессор, заведующий 2-м гинекологическим отделением (гинекологии детского и юношеского возраста), НМИЦ АГП им. ак. В.И. Кулакова; профессор кафедры акушерства, гинекологии, перинатологии и репродуктологии Института профессионального образования, ПМГМУ им. И.М. Сеченова (Сеченовский Университет).

117997, Москва, ул. Академика Опарина, д. 4; 119991, Москва, ул. Трубецкая, д. 8, стр. 2

Elena V. Uvarova - Dr. Sci. (Med.), Corr. Member RAS, Head of the 2nd Gynecology of Children and Adolescents Department, Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology; Professor at the Department of Obstetrics, Gynecology and Perinatology, Institute of Professional Education, Sechenov First Moscow State Medical University (Sechenov University).

4, Academician Oparin St., Moscow, 117997; 8, Bldg. 2, Trubetskaya St., Moscow, 119991

elena-uvarova@yandex.ruhttps://orcid.org/0000-0002-1334-2638СивириноваА. С.SivirinovaA. S.

Сивиринова Анастасия Сергеевна - аспирант факультета фундаментальной медицины.

119234, Москва, ул. Колмогорова, д. 1

Anastasia S. Sivirinova - Postgraduate Student of the Faculty of Fundamental Medicine, Lomonosov Moscow State University.

1, Kolmogorov St., Moscow, 119234

sivirinovaa@gmail.comhttps://orcid.org/0000-0001-6997-643XСальниковаС. А.SalnikovaI. A.

Сальникова Ирина Александровна - научный сотрудник 2-го гинекологического отделения.

117997, Москва, ул. Академика Опарина, д. 4

Irina A. Salnikova - Researcher of the 2nd Gynecology of Children and Adolescents Department, Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology.

4, Academician Oparin St., Moscow, 117997

i_chumakova@mail.ruКюрдзидиС. О.KyurdzidiS. O.

Кюрдзиди Станислав Олегович - аспирант кафедры акушерства, гинекологии, перинатологии и репродуктологии Института профессионального образования.

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Stanislav O. Kyurdzidi - Postgraduate Student at the Department of Obstetrics, Gynaecology and Perinatology, Institute of Professional Education, Sechenov First Moscow State Medical University (Sechenov University).

8, Bldg. 2, Trubetskaya St., Moscow, 119991

dr.kyurdzidis@gmail.comНациональный медицинский исследовательский центр акушерства, гинекологии и перинатологии имени академика В.И. КулаковаРоссияKulakov National Medical Research Center of Obstetrics, Gynecology and PerinatologyRussian FederationМосковский государственный университет имени М.В. ЛомоносоваРоссияLomonosov Moscow State UniversityRussian FederationНациональный медицинский исследовательский центр акушерства, гинекологии и перинатологии имени академика В.И. Кулакова; Первый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)РоссияKulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology; Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)Russian FederationПервый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)РоссияSechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)Russian Federation2023211020230157281Copyright © Хащенко Е.П., Алексеева М.Н., Уварова Е.В., Сивиринова А.С., Сальникова С.А., Кюрдзиди С.О., 20232023Хащенко Е.П., Алексеева М.Н., Уварова Е.В., Сивиринова А.С., Сальникова С.А., Кюрдзиди С.О.Khashchenko E.P., Alekseeva M.N., Uvarova E.V., Sivirinova A.S., Salnikova I.A., Kyurdzidi S.O.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/7798Введение

Введение. Несвоевременная диагностика и лечение эндометриоза приводят к снижению качества жизни и хронизации болевого синдрома у молодых пациенток.

Цель

Цель. Изучить показатели качества жизни, тревожности, депрессии и болевого синдрома у подростков с перитонеальным эндометриозом (ПЭ) на фоне консервативной терапии в течение 1 года.

Материалы и методы

Материалы и методы. В проспективное продольное исследование включены 45 девочек от 13 до 17 лет с подтвержденным диагнозом ПЭ. Оценка болевого синдрома (ВАШ, опросник боли Мак-Гилла), тревожно-депрессивных симптомов (шкала депрессии Бека (BDI), госпитальная шкала тревоги и депрессии (HADS), опросник Спилбергера (STAI)), показателей качества жизни (SF-36) произведена до и после 1 года лечения пациенток (диеногест в непрерывном режиме, НПВС и дротаверин с целью купирования болевого синдрома).

Результаты

Результаты. Через 1 год на фоне терапии у девочек с ПЭ значимо снизилась выраженность дисменореи и хронической тазовой боли, гастроинтестинальных симптомов и дизурии, ограничения повседневной активности и работоспособности (p < 0,001). Кроме того, отмечено снижение показателей тревожно-депрессивных расстройств (BDI депрессии, HADS тревоги и депрессии, STAI реактивной и личностной тревожности (p < 0,001)) и улучшение показателей качества жизни (физический и психологический компонент, средний индекс (p < 0,001)). Отмечена тенденция к снижению гормональных и воспалительных параметров крови на фоне лечения в пределах референсных интервалов. Показано, что уровень эстрадиола является фактором высоких значений аффективной симптоматики у подростков с ПЭ: реактивная тревожность STAI (p = 0,046), тревога и депрессия по шкале HADS (p = 0,044 и 0,033 соответственно).

Заключение

Заключение. Терапия ПЭ у подростков в течение 1 года (диеногест непрерывно, комбинация НПВС с дротаверином при болевом синдроме) была ассоциирована со значимым улучшением качества жизни, снижением выраженности тревожно-депрессивных расстройств и болевого синдрома, что подтверждает необходимость начала терапии с момента манифестации заболевания в подростковом возрасте.

Introduction

Introduction. Delayed diagnosis and treatment of endometriosis lead to impaired quality of life and pain chronification in young female patients.

Aim

Aim. To study indicators of quality of life, anxiety, depression and pain syndrome in adolescents with peritoneal endometriosis (PE) over a one-year period of conservative therapy.

Materials and methods

Materials and methods. A total of 45 girls aged 13 to 17 years with a confirmed diagnosis of PE were enrolled in a prospective longitudinal study. Pain syndrome (VAS, McGill Pain Questionnaire), anxiety-depressive symptoms (Beck Depression Inventory (BDI), Hospital Anxiety and Depression Scale (HADS), Spielberger State-Trait Anxiety Inventory (STAI)), quality of life indicators (SF-36) were assessed before and after one year of treatment in female patients (dienogest administered continuously, NSAIDs and drotaverine for immediate pain relief only).

Results

Results. One year of therapy resulted in a significant decrease in the severity of dysmenorrhea and chronic pelvic pain, gastrointestinal symptoms and dysuria, daily activity and productivity impairment (p < 0.001) in girls with PE. In addition, the study demonstrated decreased indicators of anxiety and depressive disorders (BDI depression, HADS anxiety and depression, STAI reactive and personal anxiety (p < 0.001)) and an improvement in quality-of-life indicators (physical and psychological component, average index (p < 0.001)). There was a declining trend in blood hormone and inflammation test results within the reference range during treatment. The estradiol level has been shown to be a risk factor for high levels of affective disorder symptoms in adolescents with PE: STAI reactive anxiety (p = 0.046), HADS anxiety and depression (p = 0.044 and 0.033, respectively).

Conclusion

Conclusion. The one-year therapy of PE in adolescents (dienogest administered continuously, a combination of NSAIDs and drotaverine in pain syndrome only) was associated with significantly improved quality of life, decreased severity of anxietydepressive disorders and pain, which confirms the need to start therapy when symptoms of the disease begin to show them-selves in adolescence.

перитонеальный эндометриозтазовая больдисменореятревожностьдепрессиякачество жизнидиеногестдротаверинспазмолитикperitoneal endometriosispelvic paindysmenorrheaanxietydepressionquality of lifedienogestdrotaverineantispasmodicРабота выполнена при финансовой поддержке государственного задания Минздрава России «Роль нарушений энергетического метаболизма и иммунной защиты в развитии разных форм эндометриоза, разработке персонифицированной терапии и прогнозе ее эффективности в раннем репродуктивном периоде (с менархе до 18 лет)» 18-A21.The work was carried out with the financial support of the state assignment of the Ministry of Health of Russia “The role of disorders of energy metabolism and immune defense in the development of various forms of endometriosis, the development of personalized therapy and the forecast of its effectiveness in the early reproductive period (from menarche to 18 years)” 18-A21.ReferencesSchneider MP, Vitonis AF, Fadayomi AB, Charlton BM, Missmer SA, DiVasta AD. 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The authors declare that there are no conflicts of interest present.