地诺孕素治疗子宫内膜异位症对患者生殖激素及血清CA125水平的影响

Effect of dinogestrin treatment on reproductive hormone and serum CA125 level in patients with endometriosis

目的探讨地诺孕素治疗子宫内膜异位症对患者生殖激素、血清糖类抗原125(CA125)水平的影响。方法选取90例子宫内膜异位症患者,按照随机数字表法分成甲组、乙组、丙组,每组30例。患者均实施腹腔镜下保留生育功能手术治疗,术后甲组给予口服地诺孕素6个月,乙组给予注射促性腺激素释放激素类似物(GnRHa)6个月,丙组给予口服屈螺酮烘雌醇片(II)6个月,比较三组患者治疗效果。结果甲组患者痛经、盆腔疼痛、性交痛、非经期下腹痛以及子宫活动受限占比分别为10.00%、6.67%、13.33%、13.33%、13.33%,乙组患者分别为6.67%、6.67%、10.00%、16.67%、6.67%,丙组患者分别为43.33%、46.67%、50.00%、60.00%、40.00%,甲组、乙组患者各症状、体征占比均明显低于丙组,差异有统计学意义(P<0.05),而甲组、乙组比较差异无统计学意义(P>0.05).术后6个月,甲组、乙组卵泡刺激素(FSH)、促黄体生成素(LH)、雌二醇(E_(2))、CA125水平均显著低于丙组,差异有统计学意义(P<0.05),而甲组、乙组比较差异无统计学意义(P>0.05).结论针对子宫内膜异位症,使用地诺孕素治疗可取得同GnRHa类似的效果,显著改善生殖激素水平及降低血清CA125水平,值得临床推广与应用。

Objective To investigate the effects of denorgestrel treatment on the levels of reproductive hormone and serum carbohydrate antigen 125(CA125)in patients with endometriosis.Methods 90 patients with endometriosis were selected and divided into group A,group B and group C according to random number table,30 cases in each group.All patients were treated with laparoscopic fertility preservation surgery.After surgery,group A was given oral denorgestrel for 6 months,group B was given gonadotropin-releasing hormone analogue(GnRHa)for 6 months,and group C was given oral dropirone ethinylestradiol tablet(II)for 6 months.The therapeutic effects of the three groups were compared.Results The proportions of dysmenorrhea,pelvic pain,pain during intercourse,non-menstrual subabdominal pain and uterine activity limitation were 10.00%,6.67%,13.33%,13.33%,13.33%in group A and 6.67%,6.67%,10.00%,16.67%,6.67% in group B,respectively.Patients in group C were 43.33%,46.67%,50.00%,60.00%,40.00%,respectively.The proportions of symptoms and signs in group A and B were significantly lower than those in group C,with statistical significance(P<0.05),while there was no statistical significance between group A and group B(P>0.05).Six months after surgery,The levels of serum follicle stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E_(2))and CA125 in group A and b were significantly lower than those in group C,and the differences were statistically significant(P<0.05),while there was no significant difference between group A and group B(P>0.05).Conclusion For endometriosis,the treatment of denorgestrel can achieve similar effect to GnRHa,significantly improve the level of reproductive honnones and reduce the level of serum CA125,which is worthy of clinical promotion and application.