GnRH-a联合屈螺酮炔雌醇对卵巢子宫内膜异位囊肿术后患者的疗效分析  

Analysis of the efficacy of gonadotropin-releasing hormone agonist combined with drospirenone and ethinylestradiol in postoperative patients with ovarian endometriotic cyst

作　　者：熊德玲 王茜[1] 曹庭 XIONG Deling;WANG Qian;CAO Ting(Department of Obstetrics and Gynecology,Dazhou Integrated Traditional Chinese and Western Medicine Hospital,Dazhou 635000,Sichuan,China)

机构地区：[1]达州市中西医结合医院妇产科,四川达州635000

出　　处：《中国性科学》2024年第7期43-47,共5页Chinese Journal of Human Sexuality

基　　金：四川省卫生健康委科研课题(19PJ029)。

摘　　要：目的分析促性腺激素释放激素激动剂(GnRH-a)联合屈螺酮炔雌醇对卵巢子宫内膜异位囊肿术后患者的疗效。方法选取2020年12月至2022年8月达州市中西医结合医院收治的88例卵巢子宫内膜异位囊肿患者作为研究对象,随机分为观察组(n=44)和对照组(n=44)。所有患者均接受腹腔镜下卵巢子宫内膜异位囊肿剥除术,对照组患者术后给予醋酸亮丙瑞林微球,观察组患者联合应用屈螺酮炔雌醇片。对比两组血清人附睾蛋白4(HE4)、糖类抗原125(CA125)、糖类抗原199(CA199)、雌二醇(E_(2))、黄体生成素(LH)、卵泡刺激素(FSH)、抗米勒管激素(AMH)水平及卵巢窦卵泡数(AFC),采用视觉模拟评分法(VAS)和数字评分法(NRS)评价患者主观疼痛程度,比较两组不良事件发生率和疾病复发率。结果治疗后两组血清HE4、CA125、CA199、E_(2)、LH水平及VAS、NRS评分较治疗前均显著降低,且观察组各指标均显著低于对照组(P<0.05);治疗后对照组AMH水平显著低于观察组(P<0.05)。观察组患者卵巢子宫内膜异位症复发率显著低于对照组(P<0.05)。结论GnRH-a联合屈螺酮炔雌醇能够显著降低卵巢子宫内膜异位囊肿术后患者的疼痛程度及肿瘤标志物水平,有利于患者性激素水平及损伤的卵巢储备功能恢复。同时,该联合治疗方案相比GnRH-a单药治疗能有效降低疾病复发率及不良反应发生率。Objective To investigate the efficacy of gonadotropin-releasing hormone agonist(GnRH-a)combined with drospirenone and ethinylestradiol in postoperative patients with ovarian endometriotic cyst.Methods A total of 88 patients with ovarian endometriotic cyst treated in Dazhou Integrated Traditional Chinese and Western Medicine Hospital from December 2020 to August 2022 were selected as study objects and randomly divided into observation group(n=44)and control group(n=44).All patients received laparoscopic cyst enucleation of ovarian endometriosis.Control group patients were subcutaneously injected with leuprorelin acetate microspheres,while observation group patients were combined with drospirenone and ethinylestradiol tablets.The serum levels of human epididymal protein 4(HE4),carbohydrate antigen 125(CA125),carbohydrate antigen 199(CA199),estradiol(E_(2)),luteinizing hormone(LH),follicle stimulating hormone(FSH),anti-Müllerian hormone(AMH)and the number of ovarian antral follicles(AFC)were compared between the two groups.Visual analogue score(VAS)and numeric rating scale(NRS)were used to evaluate the degree of patients′subjective pain,and the incidence of adverse events and disease recurrence rate were compared between the two groups.Results The serum HE4,CA125,CA199,E_(2),LH,VAS and NRS in both group patients were significantly lower than those before treatment,of which the observation group patients were much lower than control group(P<0.05);after treatment,the AMH level in the control group was significantly lower than that in the observation group(P<0.05).The recurrence rate of ovarian endometriosis in the observation group was significantly lower(P<0.05).Conclusions GnRH-a combined with drospirenone and ethinylestradiol can significantly reduce the degree of pain and the level of tumor markers in postoperative patients with ovarian endometriotic cyst,which is beneficial to the recovery of sex hormone levels and injured ovarian reserve function.At the same time,compared with GnRH-a monotherapy,the combined

关 键 词：促性腺激素释放激素激动剂 屈螺酮炔雌醇 卵巢子宫内膜异位囊肿 疗效 

分 类 号：R711[医药卫生—妇产科学]