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)对子宫内膜异位症患者的临床疗效及其对血管内皮生长因子(VEGF)和炎性细胞因子的影响。方法:将2013年6月—2015年9月确诊为子宫内膜异位症的82例患者纳入研究并随机分组,对照组(40例)采用腹腔镜治疗,观察组(42例)术后联合GnRH-a进行治疗。对比两组患者VEGF及肿瘤坏死因子(TNF-α)、白介素-18(IL-18)等炎症因子的改善情况。结果:两组患者均顺利完成手术,治疗后观察组的盆腔痛、痛经、性交痛的视觉模拟评分(VAS)以及雌二醇(E2)、卵泡生成激素(FSH)等均有改善,但观察组改善更显著(P<0.05);两组患者VEGF、TNF-α、IL-18水平均降低,但观察组改善更显著(P<0.05)。观察组总有效率更高。两组妊娠率比较差异有统计学意义(P<0.05)。结论:腹腔镜手术联合GnRH-a治疗子宫内膜异位症疗效显著,可有效降低VEGF和炎性细胞因子水平,提高妊娠率。
Objective： To investigate the clinical effect of laparoscopic surgery combined with gonadotropin-releasing hormone agonist（ GnRH-a） on endometriosis and its effect on vascular endothelial growth factor（ VEGF） and inflammatory cytokines. Methods： From June 2013 to September 2015,82 patients with endometriosis diagnosed as endometriosis were included in the study and randomized. Forty patients in the control group were treated with laparoscopy. 42 patients in the observation group were treated with GnRH-a,3. 75 mg one time,4 weeks 1 time,once every 3 times,12 weeks for a course of treatment.The levels of VEGF and tumor necrosis factor（ TNF-α） and interleukin-18（ IL-18） were improved. Results： The VAS score,the estradiol（ E2） and the follicle-forming hormone（ FSH） were lower in the pelvic pain,dysmenorrhea and sexual intercourse pain of the observation group after the operation,and the observation group improved more significantly（ P 0. 05）.The overall effective rate was higher in the observation group,the pregnancy rate was 64. 29%（ 27/42） and the control group was 37. 50（ P 0. 05）. The level of VEGF,TNF-α and IL-18 was lower in the treatment group than that in the control group,the difference was significant（ P 0. 05）. Conclusion： Laparoscopic surgery combined with GnRH-a treatment of endometriosis is effective,can effectively reduce the level of VEGF and inflammatory cytokines,improve the pregnancy rate.
出处
《临床医药实践》
2017年第11期803-806,共4页
Proceeding of Clinical Medicine
