经宫腹腔术联合GnRH-a治疗子宫内膜异位综合征不孕效果及对患者性激素及血清5-LOX、LXA4变化影响  

Influence of laparoscopy and hysteroscopy combined with GnRH a for treating infertility women with endometriosis on their changes of the levels of serum sex hormones, 5 LOX, and LX A4

作　　者：王亚莉 周晓莉 刘杰 赵嫦娥 吴绪峰[2] 汪黎明[2] WANG Yali;ZHOU Xiaoli;LIU Jie;ZHAO Chang’e;WU Xufeng;WANG Liming(General Hospital of Central Theater Command,Wuhan,Hubei Province;Hubei Maternal and Child Health Care Hospital)

机构地区：[1]中国人民解放军中部战区总医院,武汉430070 [2]湖北省妇幼保健院

出　　处：《中国计划生育学杂志》2020年第7期1010-1013,1017,共5页Chinese Journal of Family Planning

摘　　要：目的:探讨促性腺激素释放激素(GnRH-a)治疗子宫内膜异位综合征不孕患者宫腹腔镜术后激素水平及对血清5-脂氧化酶(5-LOX)、脂氧素A4(LXA4)影响。方法:选取2017年6月—2018年12月经本院诊治的子宫内膜异位综合征且不孕行宫-腹腔镜术后患者55例。根据患者意愿分为对照组(n=25)和观察组(n=30),对照组给予醋酸甲羟孕酮片药物治疗,观察组给予GnRH-a治疗。比较两组有效率、血清性激素及5-LOX、LXA4水平、视觉模拟评分法(VAS)评分。结果:术后1年内观察组总复发率(3.3%)低于对照组(28.0%),术后1年内妊娠率(63.3%)、2年累积临床妊娠率(76.7%)均高于对照组(28.0%、48.0%)(均P<0.05);术后生育能力观察组与对照组分别为6.03%和2.26%,两组危险度比值为2.67;两组术后雌二醇(E2)、促黄体生成素(LH)、卵泡刺激素(FSH)水平均低于术前且观察组低于对照组,LXA4、5-LOX水平均高于术前且观察组高于对照组(P<0.05);观察组患者性交痛、慢性盆腔痛、痛经评分值低于对照组(P<0.05)。结论:GnRH-a可更有利于患者术后血清5-LOX、LXA4表达提高及性激素水平调节,从而降低不孕患者术后复发率,提高妊娠率。Objective:To investigate the effect of laparoscopy and hysteroscopy combined with gonadotropin releasing hormone analogue(GnRH a)for treating infertility women with endometriosis on their levels of serum sex hormones,5 lipoxygenase(5 LOX),and lipoxin A4(LX A4).Methods:55 infertility women with endometriosis who had undergone laparoscopy combined with hysteroscopy were enrolled in this study,and were divided into two groups according to willingness of the women from June 2017 to December 2018.25 women in the control group had received medroxyprogesterone acetate tablets,while 30 women in the observation group had received GnRH a treatment.The clinical efficacy,the levels of serum sex hormones,5 LOX,and LX A4,and visual analogue scale(VAS)scores of women were compared between the two groups.Results:The total recurrence rate of women in the observation group within 1 year after surgery was 3.3%,which was significant lower than that(28.0%)of women in the control group.The cumulative clinical pregnancy rate within 1 year and 2 years after surgery were 63.3%and 76.7%,which were significant higher than those(28.0%and 48.0%)of women in the control group(all P<0.05).The postoperative fertility rate of women in the two groups were 6.03%and 2.26%,and the odd ratio of them was 2.67.After operation,the levels of E2,LH and FSH of women in both groups had decreased significantly,which of women in the observation group were significant lower than those of women in the control group,meanwhile,the levels of LXA4 and 5 LOX of women in both groups had increased significantly,which of women in the observation group were significant higher than those of women in the control group(P<0.05).The scores of sexual intercourse pain,chronic pelvic pain,and dysmenorrhea of women in the observation group were significant lower than those of women in the control group(P<0.05).Conclusion:After operation,GnRH a can effectively increase the expression levels of 5 LOX and LX A4 of infertility women with endometriosis,and can regulate their level of

关 键 词：子宫内膜异位综合征不孕 宫-腹腔镜术 促性腺激素释放激素 醋酸甲羟孕酮 性激素 5-脂氧化酶 脂氧素A4 

分 类 号：R713.4[医药卫生—妇产科学]