摘要
目的观察腹腔镜手术联合米非司酮对子宫内膜异位症患者血清巨噬细胞移动抑制因子(MIF)、血管内皮生长因子(VEGF)及其受体(VEGFR1、VEGFR2)的影响。方法选取2012年1月至2015年1月收治的子宫内膜异位症患者90例,随机分为对照组和观察组,每组45例。对照组仅采用腹腔镜手术治疗,观察组在对照组基础上联合米非司酮治疗,疗程6个月。比较2组临床疗效、1年受孕率、盆腔包块、血清hs-CRP、CA125、MIF、VEGF、VEGFR1、VEGFR2水平、生存质量量表(EHP-5)评分及复发情况。结果 (1)观察组总有效率为93.33%,对照组总有效率为75.56%,观察组总有效率显著高于对照组,差异有统计学意义(P<0.05)。观察组1年受孕率为33.33%,对照组1年受孕率为17.78%,观察组1年受孕率显著高于对照组,差异有统计学意义(P<0.05)。(2)治疗后2组盆腔包块体积、血清hs-CRP、CA125、MIF、VEGF、VEGFR1、VEGFR2水平、EHP-5评分均较治疗前有所改善,差异有统计学意义(P<0.05);但观察组改善程度优于对照组,差异有统计学意义(P<0.05)。(3)所有患者均随访1年,观察组复发率为6.67%,对照组复发率为26.67%,观察组复发率显著低于对照组,差异有统计学意义(P<0.05)。结论腹腔镜手术联合米非司酮治疗子宫内膜异位症疗效确切,可显著提高受孕率,降低术后复发率,改善患者生存质量,其机制与下调患者血清MIF、VEGF、VEGFR1、VEGFR2表达有关。
Objective To investigate the effects of mifepristone combined with laparoscopic surgery on serum macrophage migration inhibition factor（ MIF）,vascular endothelial growth factor（ VEGF） and its receptors（ VEGF1,VEGF2） in patients with endometriosis. Methods A total of 90 patients with endometriosis who were admitted into our hospital from January 2012 to January 2015 were randomly divided into observation group（ n = 45） and control group（ n =45）. The patients in control group were treated by laparoscopic surgery,however,the patients in observation group,on the basis of control group. were treated by mifepristone,with a treatment course of 6 months for both groups. After treatment,the therapeutic effects,one-year conception rate,serum levels of hs-CRP,CA125,MIF,VEGF,VEGFR1,VEGFR2 and postoperative relapse rate were observed and compared between two groups. Results The total effective rates in observation group were significantly higher than those in control group（ 93. 33% vs 75. 56%,P〈0. 05）. The one-year conception rate in observation group was significantly higher than that in control group（ 33. 33% vs 17. 78%,P〈0. 05）. After treatment,the pelvic mass volume,serum levels of hs-CRP,CA125,MIF,VEGF,VEGFR1,VEGFR2,EHP-5 scores were obviously improved,as compared with those before treatment in both groups（ P〈0. 05）,moreover,the improvement degree in observation group was superior to that of control group（ P〈0. 05）. All the patients were followed up for 1 year,the relapse rate in observation group was significantly lower than that of control group（ 6. 67% vs 26. 67%,P〈0. 05）. Conclusion The laparoscopic surgery combined with mifepristone is effective in treating endometriosis,which can obviously increase conception rate,decrease postoperative relapse rate and improve life quality of patients,and its action mechanism may be related to the down- regulation of expression levels of MIF,VEGF,VEGFR1,VEGFR2.
出处
《河北医药》
CAS
2015年第19期2900-2903,共4页
Hebei Medical Journal
关键词
子宫内膜异位症
腹腔镜手术
米非司酮
巨噬细胞移动抑制因子
血管内皮生长因子
血管内皮生长因子受体1
血管内皮生长因子受体2
endometriosis
laparoscopic surgery
mifepristone
macrophage migration inhibition factor
vascular endothelial growth factor
vascular endothelial growth factor receptor 1
vascular endothelial growth factor receptor 2
