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腹腔镜手术联合孕三烯酮治疗子宫内膜异位症合并不孕对基质金属蛋白酶及炎性因子的影响 被引量:13

Effect of laparoscopic surgery combined with gestrinone on matrix metalloproteinase and inflammatory factors in treatment of endometriosis combined with infertility
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摘要 目的探讨腹腔镜手术联合孕三烯酮治疗子宫内膜异位症合并不孕对基质金属蛋白酶(MMP)及炎性因子的影响,为子宫内膜异位症的治疗提供理论依据。方法选取2014年10月-2016年10月滕州市工人医院收治的子宫内膜异位症合并不孕患者102例为研究对象,按照随机数字表法分为观察组与对照组,每组各51例。两组均采用腹腔镜手术治疗,对照组术后常规用药治疗,观察组术后加服孕三烯酮治疗,连续服用3个月,两组均随访1年。比较两组患者手术前后内分泌激素、MMP及炎性因子水平;统计两组术后1年妊娠率、输卵管通畅率、复发率。结果与术前相比,术后3个月观察组患者血清卵泡刺激激素(FSH)、雌二醇(E_2)、黄体生成素(LH)、MMP-9/组织型基质金属蛋白酶抑制因子-1(TIMP-1)及两组MMP-9、TIMP-1、白细胞介素(IL)-4、IL-8、肿瘤坏死因子(TNF)-α、TNF-β、超敏C反应蛋白(hs-CRP)水平均显著下降,且观察组显著低于对照组,差异均有统计学意义(均P<0.01);术后1年观察组妊娠率、输卵管通畅率均显著高于对照组,而复发率低于对照组,差异均有统计学意义(均P<0.01)。结论腹腔镜手术联合孕三烯酮治疗子宫内膜异位症合并不孕可有效调节相关激素及MMP类物质水平,并抑制炎性因子释放,显著提高妊娠率及输卵管通畅率,且复发率较低。 Objective To explore the effect of laparoscopic surgery combined with gestrinone on matrix metalloproteinase(MMP) and inflammatory factors in treatment of endometriosis combined with infertility,provide a theoretical basis for treatment of endometriosis. Methods From October 2014 to October 2016,102 infertile patients with endometriosis were selected from the hospital and divided into observation group and control group according to random number table,51 patients in each group. The patients in the two groups were treated by laparoscopic surgery,then the patients in control group were treated by routine durg therapy,and the patients in observation group were treated by gestrinone after surgery for consecutive three months. The patients in the two groups were followed up for one year. The levels of endocrine hormones,MMP,and inflammatory factors before and after surgery in the two groups were compared. One-year pregnancy rates,tubal patency rates,and recurrence rates at one year after surgery were calculated in the two groups. Results Conmpared with before surgery,the levels of serum follicle-stimulating hormone(FSH),estradiol(E2),luteinizing hormone(LH),and MMP-9/tissue inhibitor of metalloproteinase-1(TIMP-1) in three months after surgery in observation group,the levels of MMP-9,TIMP-1,interleukin-4(IL-4),IL-8,tumor necrosis factor-α(TNF-α),TNF-β,and high-sensitivity C-reactive protein(hs-CRP) in the two groups decreased significantly,and the levels of above-mentioned indexes in observation group were statistically significantly lower than those in control group(P〈0. 01).The pregnancy rate and tubal patency rate in one year after surgery in observation group were statistically significantly higher than those in control group,while the recurrence rate in observation group was statistically significantly lower than that in control group(P〈0. 01). Conclusion Laparoscopic surgery combined with gestrinone can effectively regulate the levels of related hormones and MMP su
作者 甄宗慧 ZHEN Zong-Hui.(Department of Gynecology and Obstetrics, Worker's Hospital of Tengzhou City, Tengzhou, Shandong 277500, Chin)
出处 《中国妇幼保健》 CAS 2018年第10期2373-2376,共4页 Maternal and Child Health Care of China
关键词 子宫内膜异位症合并不孕 腹腔镜 孕三烯酮 基质金属蛋白酶 炎性因子 Endometriosis combined with infertility Laparoscope Gestrinone Matrix metalloproteinase Inflammatory factor
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