腹腔镜下病灶切除术联合GnRH-a对子宫内膜异位症患者生殖激素水平及Th1/Th2细胞平衡的影响  

Effects of laparoscopic focus resection combined with GnRH⁃a on reproductive hormone levels and Th1/Th2 cell balance in patients with endometriosis

作　　者：叶永生[1] 徐燕 王远航 徐小晶 孙君华 倪鸣[1] YE Yongsheng;XU Yan;WANG Yuanhang;XU Xiaojing;SUN Junhua;NI Ming(Department of Gynecology,Nanyang Central Hospital of Henan Province,Nanyang,Henan,China,473000)

机构地区：[1]河南省南阳市中心医院妇三科,河南南阳473000

出　　处：《分子诊断与治疗杂志》2024年第2期291-294,299,共5页Journal of Molecular Diagnostics and Therapy

基　　金：河南科技厅重点项目(20210506)。

摘　　要：目的 探究腹腔镜下病灶切除术联合促性腺激素释放激素激动剂(GnRH-a)对子宫内膜异位症患者生殖激素水平及辅助性T细胞1(Th1)与辅助性T细胞2(Th2)的比值(Th1/Th2)细胞平衡的影响。方法 选取2020年8月至2022年8月南阳市中心医院妇科的子宫内膜异位症患者148例,根据治疗方案分为观察组和对照组,各74例。两组均采用腔镜下病灶切除术,观察组联合GnRH-a治疗,对照组采用米非司酮片治疗,治疗6个月,比较两组患者的临床疗效、生殖激素水平、Th1/Th2细胞平衡及不良反应。结果 观察组的临床疗效为93.24%高于对照组临床疗效78.38%,差异有统计学意义(χ^(2)=6.715,P<0.05)。两组患者用药后血清卵泡刺激素(FSH)、促黄体生成素(LH)、雌二醇(E2)水平较术前均降低,且观察组低于对照组,差异有统计学意义(t=7.941,7.858,13.353,P<0.05)。两组患者用药后的血清γ干扰素(IFN-γ)、IFN-γ/白细胞介素-4(IL-4)及白细胞介素-2(IL-2)、IL-2/白细胞介素-10(IL-10)水平较术前均升高,且观察组IFN-γ、IFN-γ/IL-4及IL-2、IL-2/IL-10水平均比对照组高,差异有统计学意义(t=14.283,14.283,11.745,45.061,P<0.05);IL-4、IL-10水平较术前均降低,且观察组IL-4、IL-10水平比对照组低,差异有统计学意义(t=12.495,15.085,P<0.05)。结论 腹腔镜下病灶切除术联合GnRH-a治疗子宫内膜异位症患者,可提高临床疗效,改善患者生殖激素水平和免疫功能。Objective To explore the effects of laparoscopic resection combined with gonadotro-pin-releasing hormone agonist(GnRH-a)on reproductive hormone levels and the ratio of helper T cell 1(Th1)to helper T cell 2(Th2)cell balance in patients with endometriosis.Methods A total of 148 patients with endometriosis from the gynecology department of Nanyang Central Hospital from August 2020 to August 2022 were selected as study subjects.They were divided into two groups:an observation group and a control group based on the treatment plan,with 74 cases in each group.Both groups underwent endoscopic focal resec-tion.The observation group received treatment with GnRH-a,while the control group was treated with mife-pristone tablets for 6 months.The clinical efficacy,reproductive hormone levels,Th1/Th2 cell balance and ad-verse reactions were compared between the two groups.Results The clinical effect of the observation group was 93.24%higher than that of the control group(78.38%).The difference was statistically significant(χ^(2)=6.715,P<0.05).After treatment,the levels of serum follicle stimulating hormone(FSH),luteinizing hor-mone(LH)and estradiol(E2)decreased in both groups.The observation group had lower levels than the con-trol group,and the difference was statistically significant(t=7.941,7.858,13.353;P<0.05).The levels of se-rum interferon gamma(IFN-γ),IFN-γ/interleukin-4(IL-4),interleukin-2(IL-2)and IL-2/interleukin-10(IL-10)increased in both groups after treatment.The levels of IFN-γ,IFN-γ/IL-4,IL-2,IL-2/IL-10 in the observation group were higher than those in the control group,and the differences were statistically significant(t=14.283,14.283,11.745,45.061,P<0.05).The levels of IL-4 and IL-10 in the observation group were lower than those in the control group,and the difference was statistically significant(t=12.495,15.085,P<0.05).Conclusion Laparoscopic focal resection combined with GnRH-a in the treatment of endometriosis pa-tients can improve clinical efficacy,reproductive hormone levels and immune function.

关 键 词：腹腔镜下病灶切除术 子宫内膜异位症 促性腺激素释放激素激动剂 

分 类 号：R711.71[医药卫生—妇产科学]