达菲林联合腹腔镜术治疗子宫内膜异位症对VEGF,Ang-2和Tie-2水平的影响  

Effects of treatment of diphereline after laparoscopy surgery on levels of VEGF,Ang-2 and Tie-2 in patients with endometriosis

作　　者：王丹[1] 李怀芳[2] 

机构地区：[1]上海市第八人民医院妇产科,上海200235 [2]同济大学附属同济医院妇产科,上海200065

出　　处：《中国妇幼健康研究》2016年第8期994-997,共4页Chinese Journal of Woman and Child Health Research

基　　金：上海市徐汇区医学科研课题资助项目(编号:SHXH201207)

摘　　要：目的比较达菲林和米非司酮治疗腹腔镜术后子宫内膜异位症(EMs)的疗效,及其对性激素,血管内皮生长因子(VEGF),血管生成素(Ang)-2和血管生成素受体(Tie)-2水平的影响。方法选择2011年1月至2015年6月在上海市第八人民医院妇产科行腹腔镜下治疗并经病理证实EMs的患者90例,按照术后予以不同药物治疗分为观察组(予以达菲林治疗)和对照组(予以米非司酮治疗),每组各45例。观察两组的疗效,治疗前后盆腔包块大小、EHP-5评分、痛经评分、雌二醇(E2)、促黄体生成素(LH)、卵泡刺激素(FSH)、VEGF、Ang-2和Tie-2水平的变化,及其治疗后的不良反应。结果观察组的总有效率为91.11%,明显高于对照组的71.11%,差异有统计学意义(χ2=4.641,P<0.05)。治疗前两组的盆腔包块大小、EHP-5评分、痛经评分、E2、LH、FSH、VEGF、Ang-2和Tie-2水平差异无统计学意义(P>0.05),治疗后两组均较治疗前明显降低,而观察组较对照组降低更为明显(t包块大小=12.925,tEHP-5评分=12.842,t痛经评分=23.722,tE2=9.986,tLH=6.660,tFSH=3.321,tVEGF=8.819,tAng-2=4.921和tTie-2=5.807,均P<0.01)。观察组患者的痤疮,胃肠道反应,体重增加,围绝经期症状和潮热发生率明显高于对照组(χ2值分别为4.381、4.270、4.602、32.805、4.641,均P<0.05),两组肝功能异常发生率差异无统计学意义(χ2=0.113,P>0.05)。结论达菲林治疗EMs腹腔镜术后的疗效显著优于米非司酮,其机理可能与降低机体的性激素水平和血管生成调节因子相关,但在不良反应方面较米非司酮明显。Objective To compare the efficacy of diphereline and mifepristone in patients with endometriosis（ EMs） after laparoscopic surgery and their impact on the levels of sex hormones,vascular endothelial growth factor（ VEGF）,angiopoietin（ Ang）-2 and angiogenesis receptor（ Tie）-2. Methods Ninety patients who underwent laparoscopic surgery in the Eighth People＇s Hospital of Shanghai from January 2011 to June 2015 were pathologically confirmed with EMs and they were selected and divided into observation group（ diphereline treatment） and control group（ mifepristone treatment） according to different drug treatments with 45 cases in each group.Therapeutic efficacy,levels of pelvic mass size,EHP-5 score,dysmenorrhea score,E2,LH,FSH,VEGF,Ang-2 and Tie-2 before and after treatment as well as adverse reactions were observed in two groups. Results The total effective rate was 91. 11% in the observation group,which was significantly higher than 71. 11% in the control group,and the difference was statistically significant（ χ2= 4. 641,P〈0. 05）. The pelvic mass size,EHP-5 score,dysmenorrhea score,E2,LH,FSH,VEGF,Ang-2 and Tie-2 before treatment were not statistically different between two groups（ P〉0. 05）,while after the treatment,they were significantly lowered in two groups（ P〈0. 01）.More obvious decrease was found in the observation group compared to the control group（ t value was 12. 925,12. 842,23. 722,9. 986,6. 660,3. 321,8. 819,4. 921 and 5. 807,respectively,all P〈0. 01）. The incidences of acne,gastrointestinal reactions,weight gain,perimenopausal symptoms and hot flashes in the observation group were significantly higher than those in the control group（ χ2value was4. 381,4. 270,4. 602,32. 805 and 4. 641,respectively,all P〈0. 05）. The incidence of abnormal liver function showed no significant difference between two groups（ χ2= 0. 113,P〉0. 05）. Conclusion The efficacy of diphereline is significantly better compared to mifepristone in patients with EMs after laparos

关 键 词：子宫内膜异位症 手术治疗 达菲林 血管内皮生长因子 

分 类 号：R711.71[医药卫生—妇产科学]