腹腔镜手术联合GnRH-a药物治疗子宫内膜异位症的疗效及对血清MMIF、HE4水平的影响  

The Efficacy of Laparoscopic Surgery Combined with GnRH-a Medication in the Treatment of Endometriosis and Its Impact on Serum MMIF and HE4 Levels

作　　者：杨欣 YANG Xin(Gynecology Department,Quanzhou First Hospital,Quanzhou,Fujian 362000,China)

机构地区：[1]泉州市第一医院妇科,福建泉州362000

出　　处：《中国医药指南》2025年第9期100-102,共3页Guide of China Medicine

摘　　要：目的探索腹腔镜手术联合促性腺激素释放激素激动剂(GnRH-a)治疗子宫内膜异位症的疗效,并观察对巨噬细胞迁移抑制因子(MMIF)、人附睾蛋白4(HE4)水平的影响。方法本研究选取泉州市第一医院2018年1月至2020年1月100例子宫内膜异位症患者,利用区组随机分组法分为对照组(n=50)和试验组(n=50)。对照组采用单一腹腔镜手术治疗,试验组则在腹腔镜手术后联合GnRH-a药物治疗。比较两组治疗效果。结果治疗后,试验组患者的血清MMIF水平从(19.34±3.09)ng/ml显著降至(11.85±2.04)ng/ml,血清HE4水平从(61.76±7.55)pmol/L显著降至(47.74±6.13)pmol/L,均低于对照组(P<0.05)。在自然妊娠结局方面,试验组患者的妊娠分娩率为41.82%,足月分娩率为38.18%,均显著高于对照组的20.00%和9.09%(P<0.05)。早产率和胚胎停育率在两组间无统计学意义(P>0.05),但试验组趋势更低。结论腹腔镜手术结合GnRH-a药物治疗子宫内膜异位症,在一定程度上降低了患者血清中的MMIF和HE4水平,改善性激素水平,调节子宫内膜厚度和卵泡数,提高自然妊娠结局。Objective Exploring the efficacy of laparoscopic surgery combined with leuprorelin gonadotropin-releasing hormone(GnRH-a)drug therapy in the treatment of endometriosis,and observing the impact on the levels of macrophage migration inhibitory factor(MMIF)and human epididymis protein 4(HE4).Methods This study selected 100 patients with endometriosis from Quanzhou First Hospital from January 2018 to January 2020,and used block randomization to divide them into a control group(n=50)and an test group(n=50).The control group received single laparoscopic surgery treatment,while the test group received combined GnRH-a(leuprorelin)drug treatment after laparoscopic surgery.Comparison of treatment outcomes between the two groups.Results After treatment,the serum MMIF level of patients in the test group significantly decreased from(19.34±3.09)ng/ml to(11.85±2.04)ng/ml,and the serum HE4 level significantly decreased from(61.76±7.55)pmol/L to(47.74±6.13)pmol/L,both of which were lower than those in the control group(P<0.05).In terms of natural pregnancy outcomes,the pregnancy delivery rate of the test group patients was 41.82%,and the full-term delivery rate was 38.18%,both significantly higher than the control group’s 20.00%and 9.09%(P<0.05).There was no significant difference in premature birth rate and embryo arrest rate between the two groups(P>0.05),but the trend was lower in the test group.Conclusions Laparoscopic surgery combined with GnRH-a drug therapy for endometriosis,to some extent,reduces the levels of MMIF and HE4 in patients’serum,improves sex hormone levels,regulates endometrial thickness and follicle count,and enhances natural pregnancy outcomes.

关 键 词：腹腔镜手术 GnRH-a药物 子宫内膜异位症 血清MMIF 血清HE4 

分 类 号：R711.71[医药卫生—妇产科学]