摘要
目的:探讨子宫内膜异位症的激素治疗对卵巢纤维化和卵巢储备的影响。方法:选取2019年9月-2021年8月西安国际医学中心医院收治的86例子宫内膜异位症患者,将其随机分为四组(A、B1、B2、C),A组未接受任何激素治疗,B1组和B2组接受炔诺酮孕激素治疗,c组接受促性腺激素释放激素(GnRH)治疗。比较四组24个月复发率、复发期间肿瘤直径大小、抗苗勒激素(AMH)和促卵泡激素(FSH)水平以及血清转化生长因子-β1(TGF-β1)和平滑肌肌动蛋白(α-SMA)的表达。结果:与治疗前相比,A组斑点样出血以及痛经情况未发生变化(P>0.05),B1、B2和C组斑点样出血升高,痛经情况降低(P<0.05);治疗后,B1、B2和C组较A组斑点样出血升高、痛经情况降低,C组较B1.B2组升高(P<0.05)。与治疗期间对比,四组子宫内膜异位症复发率均发生变化(P<0.05)。在治疗期间,与A组相比,B1组、B2组和C组子宫内膜异位症复发率降低,且B1组、B2组较C组降低;在随访期.间,B1组、B2组复发率低于C组(P<0.05)。与治疗期间相比,A组随访期间子宫内膜瘤直径比较无差异(P>0.05),B1 B2和C组增大(P<0.05)。B1、B2和C组较A组子宫内膜瘤直径减小(P<0.05),而C组较B1、B2组增大(P<0.05)。与治疗前相比,四组治疗后血清FSH水平升高,血清AMH水平降低(P<0.05);治疗后,B1、B2和C组较A组血清FSH水平降低,AMH水平升高(P<0.05)。各组治疗后较治疗前TGF-β1和α-SMA的蛋白表达降低(P<0.05);治疗后BI、B2和C组较A组TGF-B1和a-SMA蛋白表达水平降低(P<0.05)。结论:与GnRH相比,孕激素可能是子宫内膜异位症术后卵巢储备和纤维治疗的更好选择。
Objective:To investigate the effect of hormone therapy for endometriosis on ovarian fibrosis and ovarian reserve.Methods:A total of 86 patients with endometriosis admitted to the Xi’an International Medical Center Hospital from September 2019-August 2021 were selected and randomly divided into four groups(A,B1,B2 and C).Group A did not receive any hormone therapy,group B1 and B2 received norethinyl progesterone therapy,and group C received GnRH therapy.The recurrence rate at 24 months,tumor diameter during recurrence,FSH and AMH levels,and serum TGF-β1 and α-SMA protein expressions were compared among the four groups.Results:Compared with before treatment,there was no change in spotty bleeding and dyspenorrhea in group A(P>0.05),spot bleeding increased and dyspenorrhea decreased in groups B1,B2 and C(P<0.05);After treatment,spotty bleeding and dyspenorrhea were increased and decreased in groups B1,B2 and C compared with group A,and increased in group C compared with group B1 and B2(P<0.05).The relapse was recorded after 12 months of treatment and 12 months of follow-up.Endometriosis recurrence rates changed in all four groups compared with the treatment period(P<0.05).During treatment,the recurrence rate of endometriosis in groups B1,B2and C was lower than that in group A,and B1 and B2 groups were lower than that in group C.During follow-up,the recurrence rate of group B1 and B2 was lower than that of group C(P<0.05).Compared with treatment,there was no difference in endometrial tumor diameter during follow-up in group A(P>0.05),increased in groups B1,B2 and C(P<0.05).The diameter of endometrioma in groups B1,B2and C was smaller than that in group A(P<0.05),and increased in group C compared with groups B1 and B2(P<0.05).Compared with before treatment,serum FSH levels were increased and serum AMH levels were decreased in four groups after treatment(P<0.05);After treatment,serum FSH levels in groups B1,B2 and C were lower than those in group A,and serum AMH levels were higher(P<0.05).The protein expressions of
作者
肖莉莎
姚青青
段世军
周妮
郭琳
张蓓蕾
XIAO Li-sha;YAO Qing-qing;DUAN Shi-jun;ZHOU Ni;GUO Lin;ZHANG Bei-lei(Gynaecology Department,Xi'an International Medical Center Hospital,Xi'an,Shaanxi,710000,China;Imaging Department,Second Afiliated Hospital ofAir Force Military Medical University,Xi'an,Shaanxi,710038,China;Gynaecology Department,The Second Affliated Hospital Of Xi'an Jiaotong University,Xian,Shaanxi,710004,China;Gynaecology Department,Second Afiliated Hospital ofAir Force Military Medical University,Xi'an,Shaanxi,710038,China)
出处
《现代生物医学进展》
CAS
2022年第9期1681-1686,共6页
Progress in Modern Biomedicine
基金
国家自然科学基金项目(81260387/H1621)。
