摘要
目的研究宫腔镜操作系统(hysteroscopy endo-operative system,HEOS)结合重组人生长激素对中重度宫腔粘连患者结缔组织生长因子(connective tissue growth factor,CTGF)、血小板衍生生长因子(platelet-derived growth factor,PDGF)、胰岛素样生长因子1(insulin-like growth factor 1,IGF-1)表达的影响。方法选取2021年1月至2022年1月宁波大学医学院附属医院收治的120例中重度宫腔粘连患者,根据随机数字表法将其分为对照组和研究组,每组各60例。两组患者均进行HEOS冷刀系统治疗,研究组患者加用重组人生长激素治疗,连续治疗14d。根据美国生育学会(American Fertility Society,AFS)评分标准评定两组患者的宫腔粘连状况,并比较两组患者治疗前后的超声指标、内膜修复因子、CTGF、PDGF、IGF-1水平及治疗期间的不良事件、疗效、痊愈患者治疗后3个月的复发率。结果治疗后,研究组患者的AFS评分、血管内皮生长因子、肿瘤坏死因子-α、转化生长因子-β1、CTGF、PDGF、IGF-1水平均显著低于对照组,超声指标、基质金属蛋白酶-9均显著高于对照组(P<0.05)。研究组患者的总有效率显著高于对照组(P<0.05)。研究组痊愈患者治疗后3个月的复发率显著低于对照组(P<0.05)。两组患者的不良事件发生率比较差异无统计学意义(P>0.05)。结论HEOS结合重组人生长激素可降低中重度宫腔粘连患者的CTGF、PDGF、IGF-1水平,抑制内膜纤维化,降低治疗后复发率。
Objective To study the effect of hysteroscopy endo-operative system(HEOS)combined with recombinant human growth hormone on connective tissue growth factor(CTGF),platelet-derived growth factor(PDGF)and insulin-like growth factor 1(IGF-1)in patients with moderate to severe intrauterine adhesions.Methods A total of 120 patients with moderate to severe intrauterine adhesions who were admitted to the Affiliated Hospital of Medical School,Ningbo University from January 2021 to January 2022 were selected and divided into control group and study group according to the random number table method,with 60 cases in each group.Both groups were treated with HEOS cold knife system.Patients in study group were treated with recombinant human growth hormone for 14 days.According the American Fertility Society(AFS)score to assess intrauterine adhesions in the two groups,and the ultrasound indicators,endometrial repair factor,CTGF,PDGF,IGF-1 before and after treatment,adverse events during treatment,efficacy,and recurrence rate of 3 months after treatment were compared between the two groups.Results After treatment,the AFS scores,vascular endothelial growth factor,tumor necrosis factor-α,transforming growth factor-β1,CTGF,PDGF and IGF-1 in study group were significantly lower than those in control group,and the ultrasound indicators,matrix metalloproteinase-9 were significantly higher than those in control group(P<0.05).The total effective rate of patients in study group was significantly higher than that in control group(P<0.05).The recurrence rate of the recovered patients in study group 3 months after treatment was significantly lower than that in control group(P<0.05).There was no significant difference in the incidence of adverse events between the two groups(P>0.05).Conclusion HEOS combined with recombinant human growth hormone can reduce the levels of CTGF,PDGF and IGF-1 in patients with moderate to severe intrauterine adhesions,inhibit endometrial fibrosis and reduce the recurrence rate after treatment.
作者
徐学麟
张永妍
XU Xuelin;ZHANG Yongyan(Department of Obstetrics and Gynecology,the Affiliated Hospital of Medical School,Ningbo University,Zhejiang,Ningbo 315000,China)
出处
《中国现代医生》
2022年第28期10-14,共5页
China Modern Doctor
基金
浙江省医药卫生科技计划项目(2022KY1151)。
关键词
宫腔镜操作系统
宫腔粘连
重组人生长激素
结缔组织生长因子
血小板衍生生长因子
胰岛素样生长因子1
Hysteroscopy endo-operative system
Intrauterine adhesions
Recombinant human growth hormone
Connective tissue growth factor
Platelet-derived growth factor
Insulin-like growth factor 1
