摘要
目的研究米非司酮联合促性腺激素释放激素激动剂(GnRH-a)治疗子宫内膜异位症(EMs)的疗效及对血清高迁移率族蛋白B1(HMGB1)、胰岛素样生长因子-1(IGF-1)水平的影响。方法选择2019年6月~2020年6月EMs患者108例,按随机数表法将其分为对照组和联合组,各54例。对照组使用米非司酮治疗,联合组使用米非司酮联合GnRH-a治疗。对比两组的临床疗效、血清HMGB1、IGF-1水平、生殖激素水平、H3K4甲基化、EMAB阳性率、Ang-2阳性率、不良反应情况。结果联合组的总有效率(85.18%)高于对照组(68.51%)(P<0.05),治疗前两组的HMGB1、IGF-1比较差异无统计学意义(P>0.05),治疗后联合组的HMGB1、IGF-1低于对照组(P<0.05);治疗前两组的促黄体生成素(LH)、卵泡刺激素(FSH)、雌二醇(E2)比较差异无统计学意义(P>0.05),治疗后联合组的LH、FSH、E2低于对照组(P<0.05),治疗前两组的H3K4甲基化、抗子宫内膜抗体(EmAb)阳性率、Ang-2阳性率比较差异无统计学意义(P>0.05),治疗后联合组的H3K4甲基化高于对照组,EmAb阳性率(31.48%)、Ang-2阳性率(33.33%)低于对照组(68.51%、64.81%)(P<0.05),联合组的不良反应总发生率(3.70%)低于对照组(16.67%)(P<0.05)。结论米非司酮联合GnRH-a治疗EMs的疗效显著,能够改善患者的血清HMGB1、IGF-1水平,降低生殖激素水平,促进H3K4甲基化、下调EmAb、Ang-2的表达,减少不良反应的发生。
Objective To study the efficacy of mifepristone combined with gonadotropin-releasing hormone agonist(GnRH-a)in the treatment of endometriosis(EMs)and its effect on serum high mobility group box 1(HMGB1)and insulin-like growth factor-1(IGF-1).Methods 108 cases of EMs patients in our hospital from June 2019 to June 2020 were selected and randomly divided into the control group and the combined group,54 cases in each group.The control group was treated with mifepristone,and the combined group was treated with mifepristone combined with GnRH-a.The clinical efficacy,serum HMGB1,IGF-1 levels,reproductive hormone levels,H3K4 methylation,EmAb positive rate,Ang-2 positive rate and adverse reactions of the two groups were compared.Results The total effective rate of the combined group(85.18%)was higher than that of the control group(68.51%)(P<0.05).Before treatment,there was no significant difference in HMGB1 and IGF-1 between the two groups(P>0.05).After treatment,HMGB1 and IGF-1 of the combined group were lower than those of the control group(P<0.05).There was no significant difference in estradiol(E2)(P>0.05).After treatment,the levels of LH,FSH and E2 in the combination group were lower than those in the control group(P<0.05).Before treatment,there was no significant difference in the methylation of H3K4,positive rate of anti endometrial antibody(EmAb)and positive rate of Ang-2 between the two groups(P>0.05).After treatment,the methylation of H3K4 in the combination group was higher than that in the control group,and the positive rate of EmAb was 31.48%.The positive rate of Ang-2(33.33%)in the combination group was lower than that in the control group(68.51%)and(64.81%)(P<0.05).The total incidence of adverse reactions in the combination group(3.70%)was lower than that in the control group(16.67%)(P<0.05).Conclusion Mifepristone Combined with GnRH-a has a significant effect in the treatment of EMs,which can improve the serum levels of HMGB1 and IGF-1,reduce the level of reproductive hormone,promote H3K4 methylation,down
作者
刘新
LIU Xin(Department of Obstetrics and Gynecology,Xiuyan Central People's Hospital,Anshan 114399,China)
出处
《中国处方药》
2022年第3期81-83,共3页
Journal of China Prescription Drug
