醋酸亮丙瑞林在子宫肌瘤合并贫血患者术前预处理中的应用  

Application of leuprelin acetate for preoperative preconditioning in patients with uterine fibroid and moderate anemia

作　　者：张月琴 刘莲莲 张春云 Zhang Yue-qin;Liu Lian-lian;Zhang Chun-yun(Department of Gynecology,Zhangjiakou Maternal and Child Health Hospital,Zhangjiakou 075000,China)

机构地区：[1]张家口市妇幼保健院妇科,张家口075000

出　　处：《中国药物应用与监测》2025年第1期78-82,共5页Chinese Journal of Drug Application and Monitoring

基　　金：张家口市重点研发计划(2221132D)。

摘　　要：目的观察米非司酮与醋酸亮丙瑞林在子宫肌瘤合并中度贫血患者术前预处理中的疗效。方法选取100例2023年1月至2024年6月张家口市妇幼保健院就诊的子宫肌瘤合并中度贫血的患者,按随机数字表法将患者分为观察组(醋酸亮丙瑞林组,50例)和对照组(米非司酮组,50例),均辅以琥珀酸亚铁缓释片纠正贫血。用药前及用药3个月后,比较两组治疗效果、子宫及肌瘤体积、血流动力学指标[子宫动脉收缩期最大流速(PSV)、舒张末期流速(EDV)、阻力指数(RI)、搏动指数(PI)]、贫血指标[红细胞数量(RBC)、平均红细胞体积(MCV)、血红蛋白(Hb)水平]、卵巢功能[雌二醇(E_(2))、促卵泡激素(FSH)、黄体生成素(LH)]、炎症因子[C反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)]和不良反应发生率。结果治疗后,醋酸亮丙瑞林组总有效率96.00%,米非司酮组为84.00%(χ^(2)=4.000,P<0.05);醋酸亮丙瑞林组子宫体积、肌瘤体积、RSV、EDV、E_(2)、FSH、LH、CRP、TNF-α、IL-6分别为[(96.87±16.31)cm^(3)、(99.05±14.97)cm^(3)、(20.39±5.24)cm·s^(-1)、(7.78±1.44)cm·s^(-1)、(55.75±8.44)pmol·L^(-1)、(4.36±0.25)IU·L^(-1)、(4.62±0.30)IU·L^(-1)、(4.72±0.54)mg·L^(-1)、(12.16±2.14)ng·mL^(-1)、(12.31±1.29)nmol·L^(-1)],均低于米非司酮组的[(99.05±14.97)cm^(3)、(28.41±5.75)cm^(3)、(26.97±4.66)cm·s^(-1)、(12.04±1.13)cm·s^(-1)、(69.31±8.65)pmol·L^(-1)、(5.01±0.18)IU·L^(-1)、(5.43±0.24)IU·L^(-1)、(7.80±0.33)mg·L^(-1)、(14.62±2.83)ng·mL^(-1)、(14.74±2.01)nmol·L^(-1)(t=2.612、2.347、6.635、16.457、7.934、14.920、14.908、34.414、4.903、7.194,均P<0.05)];醋酸亮丙瑞林组RI、PI、RBC、MCV、Hb分别为[(0.95±0.14)、(2.99±0.32)、(3.96±0.86)×10^(12)·L^(-1)、(92.06±6.31)fL、(112.85±8.89)g·L^(-1)],高于米非司酮组的[(0.89±0.12)、(2.36±0.21)、(3.41±0.45)×10^(12)·L^(-1)、(87.15±5.18)fL、(104.63±7.87)g·L^(-1),(t=2.301、11.639、4.007、4.25Objective To compare mifepristone with leuprelin acetate in the curative effect for preoperative preconditioning in patients with uterine fibroid and moderate anemia.Methods A total of 100 patients with uterine fibroid and moderate anemia admitted to Zhangjiakou Maternal and Child Health Hospital from January 2023 to June 2024 were enrolled in this study.According to random number table method,these patients were divided into the observation group(leuprelin acetate+ferrous succinate sustained-release tablets)and control group(mifepristone+ferrous succinate sustained-release tablets),with 50 in each group.Before and 3 months after medication,curative effect,uterine and fibroid volume,hemodynamics indexes(peak systolic velocity(PSV),end-diastolic velocity(EDV),resistance index(RI),pulsatility index(PI)),anema indexes(red blood cell count(RBC),mean corpuscular volume(MCV),hemoglobin(Hb)),ovarian function indexes(estradiol(E_(2)),follicle-stimulating hormone(FSH),luteinizing hormone(LH)),inflammatory factors(C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6))and incidence of adverse reactions were determined and compared between the two groups.Results After treatment,the total response rate of the observation group and control group was 96.00%and 84.00%,respectively(χ^(2)=4.000,P<0.05).The uterine volume,fibroid volume,RSV,EDV,E_(2),FSH,LH,CRP,TNF-αand IL-6 in the observation group were(96.87±16.31)cm^(3),(99.05±14.97)cm^(3),(20.39±5.24)cm·s^(-1),(7.78±1.44)cm·s^(-1),(55.75±8.44)pmol·L^(-1),(4.36±0.25)IU·L^(-1),(4.62±0.30)IU·L^(-1),(4.72±0.54)mg·L^(-1),(12.16±2.14)ng·mL^(-1)and(12.31±1.29)nmol·L^(-1),which were lower than those of(99.05±14.97)cm^(3),(28.41±5.75)cm^(3),(26.97±4.66)cm·s^(-1),(12.04±1.13)cm·s^(-1),(69.31±8.65)pmol·L^(-1),(5.01±0.18)IU·L^(-1),(5.43±0.24)IU·L^(-1),(7.80±0.33)mg·L^(-1),(14.62±2.83)ng·mL^(-1),(14.74±2.01)nmol·L^(-1)in the control(t=2.612,2.347,6.635,16.457,7.934,14.920,14.90834.414,4.903,7.194,P<0.05).However,the levels of RI,P

关 键 词：子宫肌瘤 贫血 米非司酮 醋酸亮丙瑞林 卵巢功能 炎症 

分 类 号：R556[医药卫生—血液循环系统疾病] R737.33[医药卫生—内科学]