醋酸戈舍瑞林缓释植入剂联合地屈孕酮对子宫内膜异位症患者血清VEGF、E2、CA125水平的影响  

Effect of Goserelin Acetate Sustained-Release Depot Combined with Dydrogesterone on the Serum VEGF,E2 and CA125 Levels of Patients with Endometriosis

作　　者：张燕[1] 吴英杰[1] 陈悦 冯晓娜[1] 司玉霞[1] ZHANG Yan;WU Ying-jie;CHEN Yue;FENG Xiao-na;SI Yu-xia(Department of Obstetrics and Gynecology,The First Affiliated Hospital of Jiamusi University,Jiamusi,Heilongjiang,154003,China)

机构地区：[1]佳木斯大学附属第一医院妇产科,黑龙江佳木斯154003

出　　处：《现代生物医学进展》2020年第16期3125-3128,共4页Progress in Modern Biomedicine

基　　金：黑龙江省教育厅科学技术研究项目(12531719)。

摘　　要：目的:研究醋酸戈舍瑞林缓释植入剂联合地屈孕酮对子宫内膜异位症患者血清血管内皮生长因子(vascular endothelial growth factor,VEGF)、雌二醇(Estradiol,E2)和肿瘤标志物糖类抗原125 (Carbohydrate antigen 125,CA125)水平的影响。方法:选择我院2013年1月~2017年12月收治的71例子宫内膜异位症患者,将其随机分为两组。对照组每次月经后第2 d服用地屈孕酮,每次1片,每天两次;观察组联合皮下注射醋酸戈舍瑞林缓释植入剂,每次3.6 mg,每月给药1次,共给药4次。比较两组治疗前后的血清VEGF、E2、CA125水平和子宫内膜厚度的变化。结果:治疗后,观察组的有效率为94.59%,明显高于对照组(71.43%,P<0.05)。两组治疗后的血清VEGF、E2和CA125水平均较治疗前明显降低(P<0.05),且观察组的血清VEGF、E2和CA125水平明显低于对照组(P<0.05);两组治疗后的血清基质金属蛋白酶-9(Matrix metalloproteinases-9,MMP-9)和肿瘤坏死因子(Tumor necrosis factor,TNF-α)水平均较治疗前明显降低(P<0.05),且观察组的血清MMP-9和TNF-α水平明显低于对照组(P<0.05);两组治疗后的子宫内膜厚度均较治疗前明显降低(P<0.05),且观察组的子宫内膜厚度明显低于对照组(P<0.05)。两组子宫内膜异位症患者于治疗的过程中均未出现任何与药物相关的不良反应。结论:醋酸戈舍瑞林缓释植入剂联合地屈孕酮可以有效缓解子宫内膜异位症患者的病情,可能与其改善血清VEGF、E2、CA125、MMP-9和TNF-α水平有关。Objective:To investigate the effect of Goserelin Acetate Sustained-Release Depot combined with dydrogesterone on the serum VEGF,E2 and CA125 levels of patients with endometriosis.Methods:71 cases of endometriosis admitted to our hospital from January 2013 to December 2017 were selected and randomly divided into two groups.In the control group,1 tablet of didroxyprogesterone was taken twice a day on the second day after menstruation;in the observation group,3.6 mg of goserelin acetate sustained-release implant was injected subcutaneously once a month for a total of 4 times.The levels of VEGF,E2 and CA125 and endometrial thickness before and after treatment were compared between the two groups.Results:After treatment,the effective rate of the observation group was 94.59%,significantly higher than that of the control group(71.43%,P<0.05).After treatment,the serum VEGF,E2 and CA125 levels in the two groups were significantly lower than those before treatment(P<0.05),and serum VEGF,E2 and CA125 levels in the observation group were significantly lower than those in the control group(P<0.05).After treatment,the levels of MMP-9 and TNF-αin serum of the two groups were significantly lower than those before treatment(P<0.05),and the levels of MMP-9 and TNF-αin the observation group were significantly lower than control group(P<0.05).The endometrial thickness of the two groups after treatment was significantly lower than that before treatment(P<0.05),and the observation group was significantly lower than control group(P<0.05).Patients in both groups of endometriosis did not experience any drug-related adverse reactions during treatment.Conclusion:Goserelin Acetate Sustained-Release Depot combined with dydrogesterone can effectively alleviate the patients with endometriosis,which may be related to the improvement of serum VEGF,E2,CA125,MMP-9 and TNF-αlevels.

关 键 词：醋酸戈舍瑞林缓释植入剂 地屈孕酮 子宫内膜异位症 

分 类 号：R711.71[医药卫生—妇产科学]