地诺孕素联合腹腔镜手术治疗子宫内膜异位症不孕对患者血清AMH、VEGF和临床妊娠影响  

Effects of dienogest combined with laparoscopic surgery for treating infertility patients with endometriosis on their serum anti-Mullerian hormone and vascular endothelial growth factor levels and clinical pregnancy

作　　者：邵铃 王鸿燕 杨志英 SHAO Ling;WANG Hongyan;YANG Zhiying(Anhui Wannan Rehabilitation Hospital-Wuhu Fifth People's Hospital,Anhui Province,241000)

机构地区：[1]安徽省皖南康复医院,芜湖市第五人民医院,241000

出　　处：《中国计划生育学杂志》2023年第11期2593-2596,2600,共5页Chinese Journal of Family Planning

摘　　要：目的:探究地诺孕素联合腹腔镜手术治疗子宫内膜异位症(EMT)不孕对患者血清抗缪勒管激素(AMH)、血管内皮生长因子(VEGF)水平和临床妊娠的影响。方法:选取2019年1月-2021年8月于本院就诊的EMT不孕患者122例,采用随机信封法分为对照组(n=60)与观察组(n=62),分别给予亮丙瑞林联合腹腔镜手术或地诺孕素联合腹腔镜手术治疗,连续治疗3个月。记录两组临床症状恢复情况(排卵恢复时间、月经恢复时间),治疗前及治疗3个月后卵巢功能[AMH、窦状卵泡数(AFC)、卵泡刺激素(FSH)]、血管生长因子[VEGF、碱性成纤维生长因子(bFGF)、血小板衍生生长因子(PDGF)]、炎症因子[前列腺素E2(PGE2)、前列腺素F2α(PGF2α)、C反应蛋白(CRP)],统计两组术后1年内妊娠及复发情况。结果:治疗3个月后,观察组排卵恢复时间(13.67±3.08 d)、月经恢复时间(26.13±3.76 d)均短于对照组(14.84±3.12 d、27.83±3.84 d),两组FSH、血管生长因子、炎症因子水平均低于治疗前且观察组低于对照组,两组AMH、AFC水平均低于治疗前但观察组高于对照组(均P<0.05)。术后1年内观察组自然妊娠率(64.4%)高于对照组(42.4%),复发率(6.8%)低于对照组(19.7%)(均P<0.05)。结论:地诺孕素联合腹腔镜手术可有效缩短EMT不孕症患者术后排除和月经恢复时间,改善患者卵巢功能及炎症反应水平,降低EMT术后复发风险,提高术后妊娠率。Objective:To explore the effects of dienogest combined with laparoscopic surgery for treating infertility patients with endometriosis(EMT)on levels of serum anti-Mullerian hormone(AMH)and vascular endothelial growth factor(VEGF)and clinical pregnancy.Methods:122 infertility patients with EMT were selected and divided into study group(n=62)and control group(n=60)by the random envelope method from January 2019 to August 2021.The pa tients in the control group were treated with leuprorelin combined with laparoscopic surgery for 3 months continuously after laparoscopic surgery,and the patients in the study group were treated with dienogest combined with laparoscopic surgery for 3 months continuously.The recovery status of clinical symptoms,such as ovulation recovery time and menstrual recovery time,the ovarian function,such as AMH and ollicle-stimulating hormone(FSH)levels and the antral follicle count(AFC),the levels of vascular growth factors,such as VEGF,basic fibroblast growth factor(bFGF),and platelet-derived growth factor(PDGF),and the levels of inflammatory factors,such as prostaglandin E_(2)(PGE_(2)),pros-taglandin F2α(PGF2α),and C-reactive protein(CRP),of the patients in the two groups were recorded.The pregnancy and recurrence situation of the patients in the two groups within 1 year after surgery were counted.Results:After 3 months of treatment,the ovulation recovery time(13.67±3.08 d)and the menstrual recovery time(26.13±3.76 d)of the patients in the study group were significantly shorter than those(14.84±3.12 d and 27.83±3.84 d)of the patients in the control group.The levels of FSH,vascular growth factor,and inflammatory factors of the patients in both groups after treatment had decreased significantly,and which of the patients in the study group were significantly lower than those of the patients in the control group.The AMH level and AFC of the patients in both groups after treatment had decreased significantly,and which of the patients in the study group were significantly higher than those of t

关 键 词：子宫内膜异位症 不孕 腹腔镜手术 地诺孕素 血清抗缪勒管激素 血管内皮生长因子 临床妊娠 复发 

分 类 号：R711.71[医药卫生—妇产科学] R711.6[医药卫生—临床医学]