左炔诺孕酮联合宫腔镜手术对子宫内膜息肉患者雌孕激素及血清TGF-β1水平的影响  

Effects of levonorgestrel combined with hysteroscopic surgery on estrogesterone and serum TGF-β1 levels in patients with endometrial polyps

作　　者：王华 魏涛[1] 闫翠云[1] 梁晨 WANG Hua;WEI Tao;YAN Cui-yun(Department of Obstetrics and Gynecology,Taiyuan Iron and Steel(Group)Co.,LTD.General Hospital,Taiyuan Shanxi 030008,China)

机构地区：[1]太原钢铁(集团)有限公司总医院妇产科,山西太原030008

出　　处：《临床和实验医学杂志》2023年第23期2547-2551,共5页Journal of Clinical and Experimental Medicine

基　　金：山西省卫健委科研基金项目(编号:2019364)。

摘　　要：目的探讨左炔诺孕酮联合宫腔镜手术对子宫内膜息肉(EP)患者雌孕激素及血清转化生长因子-β1(TGF-β1)水平的影响。方法前瞻性选取2020年1月至2022年1月太原钢铁(集团)有限公司总医院收治的160例EP患者纳入研究,按照随机数表法将患者分为观察组和对照组,每组各80例。观察组给予左炔诺孕酮宫内释缓系统联合宫腔镜电切术,对照组给予宫腔镜电切术。比较两组患者治疗前及治疗后3、6个月的月经失血图评分、子宫内膜厚度;比较两组治疗前及治疗后6个月的雌激素受体(ER)和孕激素受体(PR)表达水平;比较两组患者治疗前及治疗后3、6个月血清TGF-β1水平;比较两组患者的不良反应与复发情况。结果治疗后3、6个月,两组月经失血图评分均较治疗前显著降低,且观察组月经失血图评分分别为(64.36±14.96)、(45.77±12.24)分,均低于对照组[(86.71±17.28)、(52.62±15.32)分],差异均有统计学意义(P<0.05)。治疗后3、6个月,两组子宫内膜厚度均较治疗前降低,且观察组子宫内膜厚度分别为(8.12±1.64)、(4.36±0.96)mm,均低于对照组[(9.71±1.28)、(6.71±1.28)mm],差异均有统计学意义(P<0.05)。治疗后6个月,两组ER和PR表达水平均较治疗前降低,且观察组ER和PR表达水平分别为(2.71±0.26)、(2.54±0.47)pmol/mL,均低于对照组[(3.65±0.42)、(3.41±0.21)pmol/mL],差异均有统计学意义(P<0.05)。治疗后3、6个月,两组血清TGF-β1水平均较治疗前降低,且观察组TGF-β1水平分别为(92.19±10.34)、(104.36±10.54)ng/L,均低于对照组[(103.65±11.21)、(114.15±11.36)ng/L],差异均有统计学意义(P<0.05)。观察组患者不良反应总发生率和复发率分别为7.50%、10.00%,低于对照组(20.00%、22.50%),差异均有统计学意义(P<0.05)。结论左炔诺孕酮联合宫腔镜手术治疗EP患者疗效好,可以有效改善EP患者临床症状,降低ER、PR受体表达水平和TGF-β1水平,预防EP复发且安全性高。Objective To investigate the effects of levonorgestrel combined with hysteroscopic surgery on estrogesterone and serum transforming growth factor-β1(TGF-β1)levels in patients with endometrial polyps(EP).Methods A total of 160 patients with EP admitted to Taiyuan Iron and Steel(Group)Co.,LTD.General Hospital from January 2020 to January 2022 were prospectively included in the study.According to random number table method,the patients were divided into observation group and control group,each group 80 cases.The observation group received levonorgestrel combined with hysteroscopic resection,while the control group received hysteroscopic resection.Menstrual bleeding chart score,endometrial thickness before treatment and 3 months,6 months after treatment were compared in the two groups;estrogen receptor(ER)and progesterone receptor(PR)expression levels before treatment and 6 months after treatment,serum TGF-β1 level before treatment and 3 months,6 months after treatment were compared in the two groups;adverse reactions and recurrence were compared in the two groups.Results After 3 and 6 months of treatment,the menstrual bleeding chart score of two groups were significantly less than those before treatment,and the menstrual bleeding chart score of the observation group were(64.36±14.96)and(45.77±12.24)points,respectively,which were less than those of the control group[(86.71±17.28)and(52.62±15.32)points],the differences were statistically significant(P<0.05).After 3 and 6 months of treatment,the endometrial thickness in both groups were lower than those before treatment,and the endometrial thickness in the observation group were(8.12±1.64)and(4.36±0.96)mm,respectively,which were lower than those in the control group[(9.71±1.28)and(6.71±1.28)mm],the differences were statistically significant(P<0.05).After 6 months of treatment,the expression levels of ER and PR in two groups were lower than those before treatment,and the expression levels of ER and PR in the observation group were(2.71±0.26),(2.54±0.47)pmol

关 键 词：子宫内膜息肉 左炔诺孕酮 宫腔镜手术 雌孕激素 转化生长因子β1 

分 类 号：R713.4[医药卫生—妇产科学]