雌激素经阴道给药治疗卵巢早衰对子宫内膜容受性及微环境的影响  

Effects of Transvaginal Estrogen Administration on Endometrial Receptivity and Microenvironment in the Treatment of Premature Ovarian Failure

作　　者：王梅 钱丽 马莹莹 程怡文 WANG Mei;QIAN Li;MA Yingying;CHENG Yiwen(department of gynecology,panzhihua maternal and child health hospital,panzhihua,sichuan 617000,china;department of anesthesiology,panzhihua maternal and child health hospital,panzhihua,sichuan 617000,china)

机构地区：[1]攀枝花市妇幼保健院妇科,四川攀枝花617000 [2]攀枝花市妇幼保健院麻醉科,四川攀枝花617000

出　　处：《临床误诊误治》2024年第17期46-50,共5页Clinical Misdiagnosis & Mistherapy

基　　金：四川省卫生健康委科研课题(19PJ208)。

摘　　要：目的探讨雌激素经阴道给药治疗卵巢早衰对子宫内膜容受性及微环境的影响。方法选取2020年1月至2023年1月收治的90例卵巢早衰患者,以随机数字表法分为观察组45例(雌激素经阴道给药)和对照组45例(雌激素口服),连续治疗3个疗程。观察2组临床疗效和不良反应发生情况,记录2组治疗前后促黄体生成素(LH)、促卵泡生成素(FSH)、雌二醇、孕酮水平及子宫内膜厚度(ET)和子宫内膜螺旋动脉搏动指数、阻力指数,测定2组治疗前后血管内皮生长因子(VEGF)、白细胞介素-1β(IL-1β)及转化生长因子-β1(TGF-β1)水平。结果观察组与对照组总有效率分别为93.33%和77.78%,总不良反应发生率分别为8.89%和26.67%,2组间比较差异均有统计学意义(P<0.05)。治疗后2组FSH、LH水平明显降低,雌二醇、孕酮明显上升(P<0.05);治疗后观察组FSH、LH较对照组低,雌二醇较对照组高(P<0.01)。治疗后2组ET明显上升,搏动指数、阻力指数明显降低(P<0.05);且治疗后观察组ET较对照组高,搏动指数、阻力指数较对照组低(P<0.01)。治疗后2组VEGF、IL-1β、TGF-β1较治疗前显著上升,且观察组VEGF、IL-1β、TGF-β1高于对照组(P<0.05,P<0.01)。结论雌激素经阴道给药治疗卵巢早衰效果好,能有效改善性激素水平、子宫内膜容受性和相关血清学指标水平,进而调节微环境,同时不良反应少,安全性高。Objective To investigate the effects of transvaginal estrogen administration on endometrial receptivity and microenvironment in the treatment of premature ovarian failure(POF).Methods Ninety patients with POF admitted from January 2020 to January 2023 were divided into observation group(treated with estrogen via vaginal route,n=45)and control group(treated with oral estrogen,n=45)by random number table method,and were treated for 3 consecutive courses.The clinical efficacy and adverse reactions of the two groups were observed,and the levels of luteinizing hormone(LH),follicle-stimulating hormone(FSH),estradiol,progesterone,endometrial thickness(ET),as well as spiral artery pulse index and resistance index of the two groups were recorded before and after treatment.The levels of vascular endothelial growth factor(VEGF),interleukin-1β(IL-1β)and transforming growth factor-β1(TGF-β1)in the two groups were measured before and after treatment.Results The total effective rate of observation group and control group were 93.33%and 77.78%respectively,and the incidence of total adverse reactions were 8.89%and 26.67%,respectively,with statistical significance between the two groups(P<0.05).After treatment,the levels of FSH and LH in the two groups were significantly decreased,while estradiol and progesterone were significantly increased(P<0.05).After treatment,FSH and LH were lower while estradiol was higher in observation group than in the control group(P<0.01).After treatment,ET in the two groups was significantly increased,while pulse index and resistance index were significantly decreased(P<0.05).After treatment,ET in observation group was higher than that in control group,while PI and resistance index were lower than that in control group(P<0.01).VEGF,IL-1βand TGF-β1 in both groups increased significantly after treatment,which were higher in the observation group than in the control group(P<0.05,P<0.01).Conclusion Transvaginal estrogen administration in the treatment of POF is effective,which can effectively improv

关 键 词：卵巢早衰 雌激素 阴道给药 子宫内膜容受性 微环境 卵泡刺激素 血管内皮生长因子 药物毒性 

分 类 号：R711.75[医药卫生—妇产科学]