腹腔镜术后应用地屈孕酮联合醋酸亮丙瑞林治疗子宫内膜异位症的效果评估

doi:10.11655/zgywylc2024.05.012

科研成果详情

题名	腹腔镜术后应用地屈孕酮联合醋酸亮丙瑞林治疗子宫内膜异位症的效果评估
其他题名	Effect of dydrogesterone combined with leuprolide acetate in the treatment of endometriosis after laparoscopic surgery
作者	李金满 1; 夏露2
发表日期	2024-03-15
发表期刊	中国药物与临床影响因子和分区
语种	中文
原始文献类型	学术期刊
关键词	子宫内膜异位症地屈孕酮亮丙瑞林治疗结果
其他关键词	Endometriosis ; Dydrogesterone ; Leuprolide ; Treatment outcome
摘要	目的评估地屈孕酮与醋酸亮丙瑞林在子宫内膜异位症患者腹腔镜术后的协同治疗效果。方法回顾性分析2018年1月至2022年1月在苍南县第三人民医院接受腹腔镜手术的120例子宫内膜异位症患者的临床资料。根据治疗方法不同分为地屈孕酮组、醋酸亮丙瑞林组和地屈孕酮+醋酸亮丙瑞林联合组。本研究比较了3种治疗方案在治疗前后对血清性激素癌抗原125(CA125)、血管内皮生长因子（VEGF）、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、绝经症状Kupperman评分、视觉模拟疼痛评分（VAS）、治疗效果和不良反应的差异。结果治疗后，3组患者促黄体生成素（LH）、卵泡刺激激素（FSH）、雌二醇（E2）、催乳素（PRL）水平均较同组治疗前降低（P<0.05），且联合组LH、FSH、E2水平均低于地屈孕酮组和醋酸亮丙瑞林组（P<0.05），其中醋酸亮丙瑞林组E2水平下降较地屈孕酮组更明显。然而，3组的PRL水平差异无统计学意义；3组患者血清中的CA125、VEGF、TIMP和MCP-1水平在治疗后与基线相比均有所下降（P<0.05），且联合组血清CA125、VEGF、TIMP、MCP-1水平均低于地屈孕酮组和醋酸亮丙瑞林组（P<0.05），但地屈孕酮组与醋酸亮丙瑞林组比较差异无统计学意义；3组患者症状Kupperman评分与疼痛VAS评分均较本组治疗前降低，且联合组症状Kupperman评分与痛经、盆腔痛、性交痛评分均低于地屈孕酮组和醋酸亮丙瑞林组（P<0.05）；联合组总有效率为95%，高于地屈孕酮组和醋酸亮丙瑞林组（87%、83%）,1年复发率则低于地屈孕酮组和醋酸亮丙瑞林组，差异均有统计学意义（P<0.05）;3组不良反应比较，联合组总不良反应发生率为38%，与地屈孕酮组和醋酸亮丙瑞林组相比（58%、60%）降低，2组间差异有统计学意义（P<0.05）。结论腹腔镜手术后，将地屈孕酮与醋酸亮丙瑞林联合使用于子宫内膜异位症患者中，可有效调整性激素水平，缓解疼痛，临床效果显著、复发率低，且不增加不良反应发生率。
其他摘要	Objective To evaluate the efficacy of the combined administration of dydrogesterone and leuprorelin acetate in endometriosis patients who have undergone laparoscopic surgery.Methods A retrospective analysis was conducted out on 120 endometriosis patients who underwent laparoscopic surgery at Third People's Hospital of Cangnan County between January 2018 to January 2022.The patients were grouped into dydrogesterone,leuprorelin acetate,and a combined treatment group.This study evaluated the effects of dydrogesterone and leuprorelin acetate post-laparoscopy on serum levels of cancer antigen 125(CA125),vascular endothelial growth factor(VEGF),tissue inhibitors of metalloproteinases(TIMP),and monocyte chemoattractant protein-1(MCP-1).Additionally,it assessed menopausal symptoms(Kupperman score),pain intensity(visual analogue scale,VAS),overall treatment efficacy,and side effects.Results After treatment,all groups exhibited significant decreases in luteinizing hormone(LH),follicle-stimulating hormone(FSH),estradiol(E2),and prolactin(PRL)(P＜0.05).The combined group demonstrated lower levels of LH,FSH,and E2 compared to the other two groups(P＜0.05),with a notably greater decrease in E2 levels in the leuprorelin acetate group.However,no significant difference was observed in PRL levels among the groups.Serum levels of CA125,VEGF,TIMP,and MCP-1 in all groups dropped post-treatment compared to the baseline(P＜0.05),with the combined group showing lower levels than the other two groups(P＜0.05),though no significant difference was found between dydrogesterone and leuprorelin acetate groups.The combined group exhibited significantly lower Kupperman scores and VAS scores for symptoms like dysmenorrhea,pelvic pain,and pain during intercourse(P＜0.05).The overall effectiveness rate was highest in the combined group(95％)compared to the dydrogesterone(87％)and leuprorelin acetate groups(83％),with a significantly lower one-year recurrence rate(P＜0.05).Adverse reactions were lowest in the combined group(38％),significantly lower than in the other two groups(58％,60％),showing a statistically significant difference(P＜0.05).Conclusion The combined administration of dydrogesterone and leuprorelin acetate following laparoscopic surgery in patients with endometriosis effectively regulates hormone levels,alleviates pain symptoms,achieves remarkable clinical outcomes,reduces recurrence rates,and does not increase adverse reactions.
ISSN	1671-2560
卷号	24 期号:05 页码:326-331
DOI	10.11655/zgywylc2024.05.012
页数	6
收录类别	CNKI ; 维普 ; 万方
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引用统计
文献类型	期刊论文
条目标识符	https://kms.wmu.edu.cn/handle/3ETUA0LF/214799
专题	附属第二医院附属第二医院_妇科第二临床医学院、附属第二医院、育英儿童医院
作者单位	1.苍南县第三人民医院妇产科; 2.温州医科大学附属第二医院妇科
推荐引用方式 GB/T 7714	李金满,夏露. 腹腔镜术后应用地屈孕酮联合醋酸亮丙瑞林治疗子宫内膜异位症的效果评估[J]. 中国药物与临床,2024,24(05):326-331.
APA	李金满, & 夏露. (2024). 腹腔镜术后应用地屈孕酮联合醋酸亮丙瑞林治疗子宫内膜异位症的效果评估. 中国药物与临床, 24(05), 326-331.
MLA	李金满,et al."腹腔镜术后应用地屈孕酮联合醋酸亮丙瑞林治疗子宫内膜异位症的效果评估".中国药物与临床 24.05(2024):326-331.