醋酸亮丙瑞林联合地屈孕酮片对子宫内膜异位症的疗效及对血清HE4、VEGF、TIMP、MCP-1的影响

目的:探讨醋酸亮丙瑞林联合地屈孕酮片治疗子宫内膜异位症的临床疗效及对患者血清人附睾分泌蛋白4(HE4)、血管内皮生长因子(VEGF)、基质金属蛋白酶组织抑制因子(TIMP)、单核细胞趋化蛋白1(MCP-1)水平的影响。方法:选择我院2014年1月~2017年1月收治的150例子宫内膜异位症患者,按随机数表法分为对照组和研究组,每组75例。对照组予以醋酸亮丙瑞林治疗,研究组在对照组基础上联合地屈孕酮片治疗。比较两组临床疗效,治疗前后血清HE4、VEGF、TIMP、MCP-1、性激素水平、视觉模拟评分(VAS)及SF-36的变化,不良反应的发生情况和随访情况。结果:治疗后,研究组显著总有效率高于对照组(96%vs.85.33%)(P0.05);两组血清HE4、VEGF、TIMP、MCP-1、性激素、VAS水平均较治疗前显著下降,且研究组以上指标均明显低于对照组(P0.05);两组SF-36均较治疗前明显上升,且研究组明显高于对照组(P0.05)。两组不良反应发生率比较差异无统计学意义(P0.05)。随访结果显示研究组妊娠率及复发率低于对照组(P0.05)。结论:醋酸亮丙瑞林联合地屈孕酮治疗子宫内膜异位症的疗效明显优于单用醋酸亮丙瑞林治疗,其可减轻临床症状,提高妊娠几率,这可能与其有效降低血清HE4、VEGF、TIMP、MCP-1水平有关。

Curative Effect of Leuprolide Acetate Combined with Diprogesterone Tablets in Treatment Endometriosis and its Effect on Serum HE4, VEGF, TIMP and MCP-1

ABSTRACT Objective: To research the clinical curative effect of leuprolide acetate combined with diprogesterone tablets in the treatment endometriosis and its effect on the serum levels of human epididymis protein 4(HE4), vascular endothelial growth factor (VEGF), matrix metalloproteinases tissue inhibitor(TIMP), monocyte chemotactic protein-1(MCP-1). Methods: 150 cases of endometriosis patients who were treated from January 2014 to January 2017 were selected and divided into the control group and the research group, according to the random number table method, with 75 cases in each group. The control group was treated with leuprolide acetate, while the research group was treated with the diprogesterone tablets on the basis of control group. Then clinical efficacy, changes of serum HE4, VEGF, TIMP, McP-1, sex hormone level levels, visual analogue score(VAS) and sf-36 before and after treatment, the occurrence and follow-up of adverse reactions were compared between the two groups. Results: After treatment, the total effective rate of research group was significant higher than that of the control group(96% vs. 85.33%)(P<0.05). The erum levels of HE4, VEGF, TIMP, McP-1, sex hormone and VAS in both groups were significantly lower than those before treatment,the above indexes in the research group were significantly lower than those in the control group(P<0.05). The SF-36 was significantly higher in the research group than in the control group after treatment(P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Follow-up results showed that the pregnancy rate and recurrence rate in the study group were lower than those in the control group (P<0.05). Conclusion: Liangproterol acetate combined with diprogesterone was more effective than liangproterol acetate alone in the treatment of endometriosis, it could significantly relieve the clinical symptoms and improve the pregnancy rate, which may be related to its effective reduction of serum HE4, VEGF, TIMP and McP-1 levels.