宫内孕激素缓释系统辅助病灶切除对子宫腺肌病患者雌孕激素受体表达的影响

Effect of Intrauterine and Progesterone Sustained-release System Assisted Ablation on Estrogen and Progesterone Receptor Expression in Patients with Adenomyosis

目的探讨研究宫内孕激素释放系统辅助病灶切除对子宫腺肌病患者不同激素水平以及受体表达的影响。方法选取笔者医院2015年1月~2016年6月收治的子宫腺肌病患者84例作为研究对象,按照不同的治疗方式将其分为对照组和实验组,对照组40例,患者采用病灶切除治疗子宫腺肌病,实验组44例,患者采用宫内孕激素缓释系统辅助病灶切除治疗,通过对两组患者治疗后雌孕激素受体表达水平评估患者治疗效果,对比两种治疗方法的优缺点。结果两组患者在治疗前后VAS以及PBAC评分比较后得出:两组患者治疗前后VAS无明显差异且VAS分级比较,差异无统计学意义(P>0.05);在治疗后1、3以及6个月两组患者的VAS及VAS分级比较,差异均有统计学意义(P<0.05);对照组与实验组在未行治疗前,增殖期与分泌期的ER及PR在不同部位(病灶内膜及在位内膜)水平比较,差异无统计学意义,且病灶内膜的ER及PR受体均低于在位内膜,且对照组和实验组差异无统计学意义(P>0.05);对照组治疗后ER与PR水平明显增加,且实验组增加的幅度大于对照组(P<0.05);两组患者促卵泡激素(FSH)在切除前后激素水平变化明显,并在治疗后逐步降低,差异有统计学意义(P<0.05);而黄体生成素(LH)与治疗后显著降低,差异有统计学意义(P<0.05),且对患者PGF(2α)以及TXA_2得出,两组患者均比治疗前降低,且差异有统计学意义(P<0.05)。结论宫内孕激素缓释系统辅助病灶切除对子宫腺肌病患者有较好的效果,不仅能有效改善患者的临床症状,还能明显提高雌孕激素表达水平,适合临床广泛推广。

Objective To investigate the effect of assisted excision of intrauterine progesterone （PR） on different hormone levels and expression of receptor in patients with adenomyosis. Methods Totally 84 patients with adenomyosis admitted in our hospital from January 2015 to June 2016 were randomly divided into control group and experimental group according to different treatment methods. In the control group, 40 cases were treated with focal lesion 44 cases were treated with adenosine and progesterone sustained - release sys- tem. The therapeutic effect was evaluated by the expression of estrogen and progesterone receptor in the two groups after treatment. The therapeutic effects were compared between the two treatment methods The advantages and disadvantages. Results VAS and PBAC seore before and after treatment in the two groups were compared. The ~AS of the two groups before and after treatment was no significant differ- ence and VAS grading had no differenee（P 〉0.05）. 1,3 and 6 months after treatment in the two groups VAS and VAS grading were di｜~ ferent in different degree, P 〈 0.05. There was no significant difference in the ER and PR levels between the control group and the experimental group before and after treatment （P 〉 0.05）. The levels of ER and PR in the endometrium were significantly lower than those in the control group （ P 〉 0.05）. The level of ER and PR in the control group was significantly higher than that in the control group （ P 〈 0.05 ） , and there was no significant difference between the control group and the experimental group （ P 〉 0.05）. The levels of FSH and LH in the two groups were significantly lower than those before treatment （ P 〈 0.05 ） , and the difference was significant （ P 〈 0.05 ）. The difference of the levels of FSH between the two groups was statistically significant （P 〈 0.05 ） , and PGF2~ and TXA2 in patients, the two groups were lower than before treatment, and the difference was statistically significant（P 〈 0.05）. Conclusion Eetopie pregnancy and progesterone assisted resection of adenoearcinoma has a good effect on adenomyosis. It can not only improve the clinical symptoms, but a｜- so improve the expression of estrogen and progesterone.It is suitable for clinical application.