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Title:: Influence of the triptorelin on reproductive hormones, CA125, MMP-1in the treatment of endometriosis after laparoscopic conservative surgery

作者:: 蒋秀焰1; 周娟2; 1.长乐区航城街道社区卫生服务中心药剂科，福州 350200； 2.福州市长乐区医院妇产科，福州 350200

Author(s):: JIANGXiu-yan * ; ZHOUJuan; *Department ofPharmacy, HangchengStreetCommunityHealth ServiceCenter,Changle District,Fuzhou350200,China Correspondingauthor:JIANG Xiu-yan,E-mail：363701107@qq.com

关键词:: 子宫内膜异位症; 腹腔镜保守性手术; 曲普瑞林; 疗效

Keywords:: Endometriosis; Laparoscopic conservative surgery; Triptorelin; Efficacy

分类号:: R713.4

DOI:: -

摘要:: 目的探讨腹腔镜保守性手术后联合曲普瑞林治疗子宫内膜异位症对患者生殖激素、癌胚抗原125 （CA125）及基质金属蛋白酶-1（MMP-1）的影响。方法将120例行腹腔镜保守性手术治疗的子宫内膜异位症患者随机分为观察组60例和对照组60例，对照组仅进行单纯腹腔镜保守性手术治疗，观察组进行腹腔镜保守性手术后联合肌内注射普瑞林治疗。治疗前后，采用视觉模拟评分（VAS）评估并比较两组痛经改善情况，检测并比较两组血清生殖激素水平[雌二醇（E2）、促卵泡素（FSH）、促黄体素（LH）]、糖链抗原125（CA125）、基质金属蛋白酶-1（MMP-1），观察并比较两组临床疗效、复发时间及妊娠率。结果治疗后，观察组 VAS评分、E2、FSH和LH水平均低于本组治疗前和同期对照组，差异均有统计学意义（P<0.05）。治疗后，观察组CA125和MMP-1水平均低于本组治疗前和同期对照组，差异均有统计学意义（P<0.05）。观察组总有效率为48.33%，高于对照组的25.00%，差异有统计学意义（P<0.01）。观察组平均复发时间长于对照组，妊娠率高于对照组，差异均有统计学意义（P<0.01）。结论腹腔镜保守性手术后联合曲普瑞林治疗子宫内膜异位症的临床疗效确切，能够有效降低生殖激素、CA125、MMP-1水平，改善痛经症状，降低疾病复发率及延长复发时间，提高妊娠成功率，但应注意低雌激素症状，必要时进行合理的激素反向添加治疗干预。

Abstract:: Objective To observe the influence of the triptorelin on reproductive hormones, CA125, matrix metalloprotease（MMP）-1 in the treatment of endometriosis after laparoscopic conservative sur-gery. Methods Totally 120 patients with endometriosis treated with laparoscopic conservative sur-gery were randomly divided into 60 cases of the observation group and 60 cases of the observation group. The observation group were given triptorelin 3.75 mg every month after conservative laparoscop-ic surgery. Before and after treatment, the visual analogue scale （VAS）were used for evaluating the improvement of dysmenorrhea, and serum reproductive hormone levels （E2, FSH, LH）were detect-ed. The clinical efficacy, relapse time and pregnancy rate were observed and compared. Result After treatment, the VAS score, and levels of E2, FSH, and LH in the observation group were lower than those before treatment and those in the control group during the same period, and the differences were statistically significant（P<0.05）. After treatment, the levels of CA125 and MMP-1 of the ob-servation group were lower than those before treatment and those of the control group during the same period, and the differences were statistically significant（P<0.05）. The total effective rate of the ob-servation group was 48.33%, which was higher than25.00% of the control group, and the difference was statistically significant（P<0.01）. The average recurrence time of the observation group was lon-ger than that of the control group, and the pregnancy rate of the observation group was higher than that of the control group. The differences were statistically significant （P<0.01）. Conclusion The laparoscopic conservative surgery combined with triptorelin had exact clinical efficacy, which can effec-tively reduce the reproductive hormone, CA125 and MMP-1, improve symptoms of dysmenorrhea, lower relapse rate and prolong time to recurrence and improve the success rate of pregnancy in the treatment of endometriosis, but low estrogen symptoms should be cared for taking add-back therapy.

参考文献/References:

[1] 乐杰,谢幸,丰有吉.妇产科学[M].6版.北京:人民卫生出版社, 2005:354-361. [2] 张绍芬.绝经-内分泌与临床[M].北京:人民卫生出版社,2005:253. [3] 丁辉.子宫内膜异位症患者VEGF、TNF-α和IL-6的表达及与 R-AFS分期的相关性研究[J].临床和实验医学杂志,2014,13 (20):1690-1693. [4] 姚晓芳,周爱智.手术联合曲普瑞林治疗子宫内膜异位症观察[J]. 中华全科医学,2013,11(2):258-260. [5] 朗景和.子宫内膜异位症的诊断与治疗规范[J].中华妇产科杂志, 2007,9(42):645-648. [6] 向亚利,毛平.腹腔镜下个体化手术联合促性腺激素释放激素激动剂治疗子宫内膜异位症75例疗效观察[J].中国内镜杂志,2015, 21(1):59-61. [7] 张蓉,侯文静.以血管生成相关分子为靶向的子宫内膜异位症的个体化治疗研究[J].中国临床医学,2013,20(5):745-746. [8] 李政,岳天孚.曲普瑞林治疗子宫内膜异位症应个体化[J].国际妇产科学杂志,2011,38(4):281-284. [9] 谭红.曲普瑞林在子宫内膜异位症术后的临床应用[J].药物流行病学杂志,2004,13(4):180-182. [10] 程红,宋秀珍.腹腔镜联合药物治疗子宫内膜异位症80例疗效观察[J].中国妇幼保健,2010,25(5):708-709.

《慢性病学杂志》[ISSN:1674-8166/CN:11-5900/R]

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