不同剂量米非司酮与地诺孕素联合治疗子宫内膜异位症疗效及对患者血管新生的影响  

Efficacy of different doses of mifepristone combined with dienogest on endometriosis and its influence on angiogenesis

作　　者：韩素彬 李文 黄彬彬 刘海凤 HAN Subin;LI Wen;HUANG Binbin;LIU Haifeng(Department of Obstetrics and Gynecology,The second Affiliated Hospital of Chengdu Medical College China National Nuclear Corporation 416 Hospital,Chengdu Sichuan,610051,China)

机构地区：[1]成都医学院第二附属医院·核工业四一六医院妇产科,四川成都610051

出　　处：《中国妇产科临床杂志》2024年第5期438-441,共4页Chinese Journal of Clinical Obstetrics and Gynecology

基　　金：四川省自然科学基金(2022NSFSC0776);成都医学院校基金(CYZYB21-01)。

摘　　要：目的观察采用不同剂量的米非司酮与地诺孕素联合治疗在子宫内膜异位症(EMT)中的应用,并分析其对血管新生的影响。方法纳入2021年1月至2023年1月成都医学院第二附属医院·核工业四一六医院收治的204例EMT患者为研究对象,利用数字随机法将入组患者均分为四组:未治疗组、米非司酮组、地诺孕素组和联合组,比较组间疗效、性激素、炎性因子、氧化应激因子、血管新生指标情况。结果经治疗的三组临床疗效比较差异无统计学意义(P>0.05)。治疗后四组雌二醇(E2)、孕酮(P)和卵泡刺激素(FSH)白介素-1β(IL-1β)、白介素-17(IL-17)、金属基质蛋白酶-9(MMP-9)、血管内皮生长因子(VEGF)、血管生成素-Ⅱ(Ang-Ⅱ)、活性氧簇(ROS)、超氧化物歧化酶(SOD)水平差异明显(P<0.05),其中地诺孕素组、米非司酮组和联合组E2、P、FSH、IL-1β、IL-17、MMP-9、Ang-Ⅱ、VEGF、ROS水平均明显低于未治疗组(P<0.05),而联合组明显低于地诺孕素组和米非司酮组(P<0.05),治疗组SOD水平均明显高于未治疗组(P<0.05),联合组明显高于地诺孕素组和米非司酮组(P<0.05)。三组药物副反应总发生率差异均无统计学意义(P>0.05)。结论小剂量米非司酮与地诺孕素联合治疗EMT能有效抑制机体炎症、氧化应激和血管新生因子,安全性较好。Objective To observe the application of different doses of mifepristone combined with dienogest in the treatment of endometriosis(EMT)and analyze its influence on angiogenesis.Methods A total of 204 patients with EMT from Jan 2021 to Jan 2023 were enrolled in the secoand Affiliated Hospital of Chengdu Medical College·China National Nuclear corporation 4l6 Hospital as the study subjects.The patient were equally divided into four group using a numerical randomization method,including untreated group,mifepristone group,dienogest group and combined group.The efficacy,sex hormones,inflammatory factors,oxidative stress factors and angiogenesis indicators were compared among the groups.Results There was no significant difference in the clinical efficacy among the three treated groups(P>0.05).After treatment,the levels of estradiol(E2),progesterone(P),follicle stimulating hormone(FSH),interleukin-1β(IL-1β),interleukin-17(IL-17),matrix metalloproteinase-9(MMP-9),vascular endothelial growth factor(VEGF),angiopoietin-Ⅱ(Ang-Ⅱ),reactive oxygen species(ROS)and superoxide dismutase(SOD)in the four groups were significantly different(P<0.05),and the E2,P,FSH,IL-1β,IL-17,MMP-9,Ang-Ⅱ,VEGF and ROS levels in dienogest group,mifepristone group and combined group were significantly lower than those in untreated group(P<0.05),and the above levels in combined group were significantly lower than those in dienogest group and mifepristone group(P<0.05),and the level of SOD was significantly higher than that in untreated group(P<0.05),and the level was significantly higher in combined group compared to dienogest group and mifepristone group(P<0.05).There was no obvious difference in the total incidence rate of adverse drug reactions among the three treated groups(P>0.05).Conclusion The combination of small-dose mifepristone and dienogest in the treatment of EMT can effectively inhibit body’s inflammation,oxidative stress and angiogenesis factors,and it has good safety.

关 键 词：子宫内膜异位症 米非司酮 地诺孕素 血管新生 

分 类 号：R711.71[医药卫生—妇产科学]