左炔诺孕酮对无排卵型功能失调性子宫出血患者子宫内膜血管内皮细胞生长因子、雌激素受体、孕激素受体及血清激素的影响

Influence of Levonorgestrel on the endometrium VEGF,ER,PR and serum hormone of patients with anovulatory functional bleeding

目的探讨左炔诺孕酮对无排卵型功能失调性子宫出血(功血)患者子宫内膜血管内皮细胞生长因子(VEGF)、雌激素受体(ER)、孕激素受体(PR)及血清激素的影响。方法选取2011年3月～2012年7月采用妈富隆进行治疗的28例无排卵型功血患者为对照组,同期采用左炔诺孕酮进行治疗的28例患者为观察组。将两组患者治疗前与治疗后1、3、6个月的子宫内膜腺体及间质中的VEGF、ER、PR、血清激素水平及相关检测指标进行比较。结果观察组治疗后1、3、6个月的子宫内膜腺体及间质中的VEGF分别为64.29%、71.43%、78.57%和57.14%、64.29%、75.00%,血清孕酮(P)为(3.49±0.26)、(3.80±0.29)ng/mL和(3.93±0.32)ng/mL,均高于对照组;ER、PR及血清雌二醇(E2)均低于对照组,差异均有统计学意义(均P<0.05)。而垂体分泌卵泡刺激素(FSH)及促黄体生成激素(LH)则无明显差异(均P>0.05),且患者的子宫内膜厚度小于对照组,血红蛋白水平高于对照组,PBAC评分低于对照组,不良反应发生率也低于对照组,差异均有统计学意义(均P<0.05)。结论左炔诺孕酮对无排卵型功血子宫内膜VEGF、ER、PR及血清E2、P的影响较大,并有效改善了疾病的其他相关评估指标。

Objective To study the influence of Levonorgestrel for the endometrium vascular endothelial growth factors （VEGF）, estrogen receptor （ER）, progesterone receptor （PR） and serum hormone of patients with anovulatory functional bleeding. Methods 28 patients with anovulatory functional bleeding treated with Marvelon from March 2011 to July 2012 were the control group, and 28 cases treated with Levonorgestrel at the same time were the observation group, then the endometrium gland and stromal VEGF, ER, PR, serum hormone before and after treatment for 1, 3 and 6 months and other related items of two groups were compared. Results The endometrium gland and stromal VEGF of observation group after treatment for 1, 3 and 6 months were 64.29%, 71.43%, 78.57% and 57.14%, 64.29%, 75.00%, serum progesterone （P） were （3.49±0.26） ng/mL, （3.80±0.29） ng/mL and （3.93＋0.32） ng/mL, and they were higher than those of control group, ER, PR and serum estradiol （E2） were lower than those of control group, there were all significant differences （all P 〈 0.05）, while follicle-stimulating hormone （FSH） and luteinizing hormone （LH） had no significant differences （all P 〉 0.05）, while the endometrial thickness was smaller than that of control group, hemoglobin level was higher than that of control group, PBAC scores were all lower than those of control group, incidence of adverse reactions was lower than that of control group, there were all significant differences （all P 〈 0.05）. Conclusion The influence of Levonorgestrel for the endometrium VEGF, ER, PR and serum E2, P of patients with anovulatory functional bleeding is great, and it effectively improve other related indexes of disease.