地诺孕素治疗子宫内膜异位症疗效及其作用机制分析  

Efficacy and the mechanism of dienogest for treating patients with endometriosis

作　　者：胡红彦 HU Hongyan(Cangzhou Maternal and Child Health Care Hospital,Hebei Province,061000)

机构地区：[1]河北省沧州市妇幼保健院,061000

出　　处：《中国计划生育学杂志》2025年第3期572-576,共5页Chinese Journal of Family Planning

摘　　要：目的:探究地诺孕素治疗子宫内膜异位症(EMT)疗效及其作用机制。方法:选取2021年1月-2023年6月本院收治的EMT患者86例,随机数字表法分为两组各43例,分别给予孕三烯酮(孕三烯酮组)或地诺孕素(地诺孕素组),比较两组临床疗效、治疗前后临床症状积分(经行腹痛、非经期下腹痛、性交痛、非经期肛门坠痛),异位囊肿包块直径、疼痛评分[视觉模拟评分(VAS)]、痛经症状量表(CMSS)评分、雌激素(E2)、促卵泡生成激素(FSH)、促黄体生成素(LH)、抗缪勒管激素(AMH),基质金属蛋白酶(MMP)-3、MMP-9、转化生长因子-1(TGF-β1)及血管内皮生长因子(VEGF)水平变化。结果:治疗后总有效率地诺孕素组(88.4%)高于孕三烯酮组(69.8%);两组经行腹痛、非经期下腹痛、性交痛、非经期肛门坠痛症状积分下降,且地诺孕素组低于孕三烯酮组;两组异位囊肿包块直径减小,疼痛评分均降低,且地诺孕素组异位囊肿包块直径(0.73±0.05cm)小于孕三烯酮组(1.15±0.26cm),VAS(1.67±1.04分)、CMSS(4.45±1.46分)评分均低于孕三烯酮组(2.75±1.05分、7.27±1.91分);两组血清E2、FSH、LH及AMH均下降,且地诺孕素组均低于孕三烯酮组;两组血清MMP-3、MMP-9、TGF-β1、VEGF水平均下降,且地诺孕素组均低于孕三烯酮组(均P<0.05)。结论:地诺孕素治疗EMT疗效提高,可显著改善患者痛经症状和卵巢功能,其机制可能与调节MMP-3、MMP-9、TGF-β1、VEGF的表达有关。Objective:To investigate the efficacy and the mechanism of dienogest for treating patients with endometriosis(EMT).Methods:A total of 86 patients with EMT who admitted in the hospital were selected and were randomly divided into two groups(43 patients in each group)between January 2021 and June 2023.The patients in the control group were treated with gestrinone,while the patients in the observation group were treated with dienogest.The clinical efficacy,the clinical symptom scores of the menstrual abdominal pain,non-menstrual lower abdominal pain,pain during intercourse and non-menstrual anal pain before and after treatment,the ectopic cyst mass diameter,the pain score evaluated by visual analogue scale(VAS),the dysmenorrhea symptom scale(CMSS)score,the levels changes of estrogen(E,),follicle-stimulating hormone(FSH),luteinizing hormone(LH),anti-millerian hormone(AMH),matrix metalloproteinases(MMP)-3,MMP-9,transforming growth factor-beta 1(TGF-β1)and vascular endothelial growth factor(VEGF)of the patients were compared between the two groups.Results:After treatment,the total effective rate(88.4%)of the patients in the observation group was significantly higher than that(69.8%)of the patients in the control group.The symptom scores of abdominal pain,non-menstrual lower abdominal pain,dyspareunia and non-menstrual anal falling pain of the patients in the two groups after treatment had decreased significantly,and which of the patients in the observation group were significantly lower than those of the patients in the control group.The diameter of the ectopic cyst mass and the pain score of the patients in the two groups after treatment had decreased significantly,and the diameter of the ectopic cyst mass(0.73±0.05cm)of the patients in the observation group was significantly smaller than that(1.15±0.26cm)of the patients in the control group.The scores of VAS(1.67±1.04 points)and CMSS(4.45±1.46 points)of the patients in the observation group were significantly lower than those(2.75±1.05 points and 7.27±1.91 poi

关 键 词：子宫内膜异位症 地诺孕素 孕三稀酮 机制 痛经 卵巢功能 基质金属蛋白 

分 类 号：R71[医药卫生—妇产科学]