雌雄激素比值预测复发性子宫内膜异位症术后疼痛缓解程度  

Estrogen-androgen ratio for prediction of pain relief after surgery for recurrent endometriosis

作　　者：李艳秋 韩立薇 韦成厚 张碧云 舒小妹 李玉华 LI Yan-qiu;HAN Li-wei;WEI Cheng-hou(Guangdong Provincial Institute of Family Planning Science and Technology(Guangdong Provincial Family Planning Special Hospital),Guangzhou 510600,China)

机构地区：[1]广东省计划生育科学技术研究所(广东省计划生育专科医院),510600

出　　处：《中国实用医药》2020年第13期14-17,共4页China Practical Medicine

基　　金：广东省计划生育科学技术研究所项目(项目编号:S2018003)。

摘　　要：目的评估雌雄激素比值预测复发性子宫内膜异位症(EMs)术后疼痛缓解程度的价值。方法回顾性分析104例复发性子宫内膜异位症患者的临床资料,根据术后疼痛是否消除分为A组(58例,患者疼痛情况明显好转或消除)和B组(46例,患者疼痛症状无变化),对两组患者进行血清学检测和B超检查,比较所有患者治疗前、治疗后6个月疼痛评分以及癌胚抗原125(CA125)、性激素[垂体分泌卵泡刺激素(FSH)、促黄体生成素(LH)、雌二醇(E2)、孕酮(P)、催乳素(PRL)、睾酮(T)]水平;比较两组患者治疗前年龄、病程、CA125、疼痛评分、性激素水平、子宫内膜异位症分期评分以及治疗后疼痛评分和CA125、E2、T、E2/T、FSH、LH、P、PRL水平。结果104例患者治疗6个月后疼痛评分以及CA125、FSH、LH、E2、PRL水平分别为(4.82±1.71)分、(32.27±10.27)U/ml、(4.67±0.80)mIU/ml、(4.07±0.53)mIU/ml、(45.11±8.35)pmol/L、(122.76±9.66)μmol/L,均低于治疗前的(7.56±1.07)分、(66.86±10.65)U/ml、(6.67±0.83)mIU/ml、(5.02±0.55)mIU/ml、(71.49±12.30)pmol/L、(130.26±14.62)μmol/L,差异均具有统计学意义(P<0.05)。患者治疗前后P、T水平比较差异无统计学意义(P>0.05)。治疗后,A组疼痛评分(3.41±0.79)分、E2/T(62.21±22.88)均低于B组的(6.59±0.49)分、(73.38±21.13),CA125(35.09±10.33)U/ml、T(0.82±0.30)nmol/L均高于B组的(28.71±9.00)U/ml、(0.82±0.30)nmol/L,差异均具有统计学意义(P<0.05),E2/T与疼痛评分呈正相关(r=0.272,P<0.05)。两组E2、FSH、LH、P、PRL水平比较,差异均无统计学意义(P>0.05)。结论联合雌雄激素比值能更准确预测复发性子宫内膜异位症术后疼痛症状的缓解情况,值得临床推广。Objective To evaluate the value of estrogen-androgen ratio for prediction of pain relief after surgery for recurrent endometriosis(EMs).Methods A total of 104 patients with recurrent endometriosis were divided into group A(58 cases,with obviously improved or eliminated pain symptom)and group B(46 cases,with no change in pain symptoms)according to whether the postoperative pain is eliminated.Both groups of patients were tested by serology and B-ultrasound.The pain score,and levels of aancer antigen 125(CA125),sex hormone[follicle stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2),progesterone(P),prolactin(PRL),testosterone(T)]before treatment and after 6 months of treatment were compared between the two groups.The age,course of disease,CA125,pain score,sex hormone level,endometriosis staging score before treatment,and pain score,CA125,E2,T,E2/T,FSH,LH,P,PRL levels were compared between the two groups.Results After 6 months of treatment,the pain score and levels of CA125,FSH,LH,E2 and PRL of 104 patients were(4.82±1.71)points,(32.27±10.27)U/ml,(4.67±0.80)mIU/ml,(4.07±0.53)mIU/ml,(45.11±8.35)pmol/L,(122.76±9.66)μmol/L respectively,which were all lower than those before treatment(7.56±1.07)points,(66.86±10.65)U/ml,(6.67±0.83)mIU/ml,(5.02±0.55)mIU/ml,(71.49±12.30)pmol/L,and(130.26±14.62)μmol/L,and the difference was statistically significant(P<0.05).There was no statistically significant difference in levels of P and T before and after treatment(P>0.05).After treatment,the pain score(3.41±0.79)points and E2/T(62.21±22.88)of group A were lower than those of group B(6.59±0.49)points and(73.38±21.13),and CA125(35.09±10.33)U/ml and T(0.82±0.30)nmol/L were higher than those of group B(28.71±9.00)U/ml and(0.82±0.30)nmol/L.The difference was statistically significant(P<0.05).E2/T was positively correlated with pain symptom score(r=0.272,P<0.05).There was no statistically significant difference in levels of E2,FSH,LH,P,and PRL between the two groups(P>0.05).Conclusion The combination of estro

关 键 词：子宫内膜异位症 雌激素 雄激素 疼痛 

分 类 号：R713.4[医药卫生—妇产科学]