摘要
目的探讨腹腔镜手术联合促性腺激素释放激素激动剂(GnRH-a)治疗对子宫内膜异位症患者血清性激素、细胞因子及预后的影响。方法 160例子宫内膜异位症患者随机分为研究组与对照组,每组80例。对照组采用腹腔镜手术治疗,研究组采用腹腔镜手术联合GnRH-a治疗。比较两组治疗前后血清性激素、调节活化正常T细胞表达与分泌的趋化因子(RANTES)及高迁移率组蛋白B1(HMGB1)水平,观察两组治疗期间不良反应发生情况。术后随访1年,观察两组痛经发生率、子宫内膜异位症复发率及妊娠率。结果两组治疗前血清雌二醇、孕酮、促卵泡激素(FSH)、黄体生成素(LH)、RANTES及HMGB1水平比较,差异均无统计学意义(均P>0.05);治疗后6个月,研究组血清雌二醇、孕酮、RANTES及HMGB1水平均低于对照组(均P<0.05);但两组血清FSH、LH水平比较,差异均无统计学意义(均P>0.05)。研究组总不良反应发生率、痛经发生率及子宫内膜异位复发率均低于对照组,妊娠率高于对照组(均P<0.05)。结论采用腹腔镜手术联合GnRH-a治疗子宫内膜异位症,可有效降低复发率及痛经发生率,提高妊娠率,其作用机制可能与改善血清性激素水平、降低血清RANTES及HMGB1蛋白水平有关。
Objective To investigate the effect of laparoscopic surgery combined with gonadotropin-releasing hormone agonist(GnRH-a) on serum sex hormones,cytokines and prognosis in patients with endometriosis. Methods A total of 160 patients with endometriosis were randomly divided into study group and control group,with 80 cases in each group.The control group was treated with laparoscopic surgery,while the study group was treated with laparoscopic surgery combined with GnRH-a.Serum hormones,regulated upon activation normal T cell expressed and secreted factor(RANTES) and high mobility group box 1(HMGB1) levels were compared between the two groups before and after treatment,the incidence of adverse reactions during treatment was observed in the two groups.After 1 year of follow-up, incidence rate of dysmenorrhea,incidence rate of endometriosis recurrence,and pregnancy rate were observed in the two groups. Results There was no statistically significant difference in serum estradiol,progesterone,follicle-stimulating hormone(FSH),luteinizing hormone(LH),RANTES or HMGB1 level between the two groups before treatment (all P >0.05);after 6 months of treatment,the study group had lower levels of serum estradiol,progesterone,RANTES and HMGB1 than the control group(all P <0.05);however,there was no statistically significant difference in serum FSH or LH level between the two groups(all P >0.05).The study group had a lower incidence rate of total adverse reactions, lower incidence rates of dysmenorrhea and endometriosis recurrence,and a higher pregnancy rate than the control group(all P <0.05). Conclusion The use of laparoscopic surgery combined with GnRH-a can effectively reduce the incidence rates of dysmenorrhea and endometriosis recurrence as well as improve pregnancy rate in the treatment of endometriosis ,and its functional mechanism may be related to improvement in serum sex hormones levels and decreased serum RANTES and HMGB1 protein levels.
作者
姜琳
王金梅
JIANG Lin;WANG Jin-mei(Department of Gynecology,North Branch,the First People′s Hospital of Urumqi,Urumqi 830000,China)
出处
《广西医学》
CAS
2019年第13期1658-1661,共4页
Guangxi Medical Journal
关键词
子宫内膜异位症
促性腺激素释放激素激动剂
腹腔镜手术
性激素
调节活化正常T细胞表达与分泌的趋化因子
高迁移率组蛋白B1
妊娠
痛经
复发
预后
Endometriosis
Gonadotropin-releasing hormone agonist
Laparoscopic surgery
Sex hormone
Regulated upon activation normal T cell expressed and secreted factor
Regulator of activation
High mobility group box 1
Pregnancy
Dysmenorrhea
Recurrence
Prognosis
