摘要
目的:探讨卵巢子宫内膜异位囊肿行囊肿剔除术后采用促性腺激素释放激素α(GnRH-α)与孕三烯酮治疗效果及对患者激素、辅助性T(Th)细胞因子、抗苗勒管激素(AMH)和肿瘤标志物(CA125)水平的影响。方法:本院2016年1月-2018年1月收治的卵巢子宫内膜异位囊肿患者90例,随机数字表法分为观察组和对照组各45例,两组均行卵巢囊肿剔除术治疗,术后观察组给予GnRH-α、对照组给予孕三烯酮治疗。统计两组临床疗效,对比两组治疗前后血清卵泡刺激素(FSH)、雌二醇(E2)、FSH/促黄体生成素(LH)、Th细胞因子、AMH和CA125水平,随访1年统计复发率和妊娠率。结果:观察组治疗总有效率(97.8%)高于对照组(80.0%),治疗后两组血清FSH、E2、FSH/LH和CA125水平均降低,AMH水平升高,且观察组变化幅度高于对照组(均P<0.05);观察组血清白细胞介素-2(IL-2)、γ干扰素(IFN-γ)水平高于对照组,白细胞介素-4(IL-4)和白细胞介素-10(IL-10)水平低于对照组,复发率(6.7%)低于对照组(20.0%),妊娠率(60.0%)高于对照组(40.0%)(均P<0.05)。结论:卵巢子宫内膜异位囊肿患者行囊肿剔除术后辅助GnRH-α治疗效果优于孕三烯酮,可更好改善患者性激素水平和AMH、CA125水平,恢复Th细胞因子平衡,减少术后复发率,提高妊娠率。
Objective: To investigate the effect of gonadotropin-releasing hormone α(GnRH-α) and gestrinone for treating women with ovarian endometriosis cysts after ovarian cystectomy, and to study their influence on the levels of serum hormone, assisted T(Th) cytokines, anti-Mullerian hormones(AMH), and the effect of tumor marker CA125. Methods: 90 women who had experienced ovarian endometriosis cystectomy were selected and were divided into observation group and control group(45 cases in each group) according to the random number table method from January 2016 to January 2018. Then the women in the observation group were given GnRH-α, and the women in the control group were given gestrinone. The clinical efficacy of the women in the two groups was analyzed. The levels of serum follicle stimulating hormone(FSH), estradiol(E2), FSH/Luteinizing Hormone(LH), Th cytokine, AMH, and CA125 of the women in the two groups were compared before and after treatment. And the recurrence rate and pregnancy rate of women in the two groups were followed up for 1 year. Results: The total effective rate of women in the observation group was 97.8%, which was significant higher than that(80.0%) of women in the control group. After treatment, the levels of serum FSH, E2, FSH/LH, and CA125 of women in the two groups had decreased significantly, while the level of AMH had increased significantly, and which’s changes of women in the observation group was significant more than those of women in the control group(P<0.05). The levels of interleukin-2(IL-2) and interferonγ(IFN-γ)of women in the observation group were significant higher than those of women in the control group,but the levels of interleukin-4(IL-4)and interleukin-10(IL-10)of women in the observation group were significant lower.The recurrence rate of women in the observation group was 6.78%,which was significant lower than that(20.0%)of women in the control group.The pregnancy rate of women in the observation group was 60.0%,which was significant higher than that(40.0%)of women in the control group(all P<0.05).Conclusion:The therapeutic effect of GnRH-a for adjuvant treating women after ovarian endometriosis cystectomy is better than that of gestrinone treatment,which can significantly improve the levels of sex hormones,AMH and CA125,can restore the balance of Th cell factor,can reduce the recurrence rate,and can increase the pregnancy rate.
作者
李娟
雷月
朱烨
LI Juan;LEI Yue;ZHU Ye(Women's Hospital Affiliated to Nanjing Medical University,Nanjing Maternity and Child Health Care Hospital,Jiangsu Province,210000)
出处
《中国计划生育学杂志》
2020年第10期1570-1573,共4页
Chinese Journal of Family Planning
