GnRH-a治疗子宫内膜异位症对于患者FSH E2 IL-18及TNF-α等的变化影响

目的 探讨GnRH-a治疗子宫内膜异位症（EM）对于患者FSH、E2水平、IL-18及TNF-α等的变化影响.方法 选取2014年1月至2017年1月接受治疗的非手术的EM患者为观察对象,根据其治疗方式分为对照组和观察组,观察组给予GnRh-a治疗,对照组给予米非司酮治疗,两组患者均接受3-6个月的治疗.观察两组患者治疗前后疼痛评分、性激素水平、细胞因子水平、子宫内膜厚度和性生活质量的差异.结果 两组患者治疗前疼痛评分无明显差异（P〉0.05）,治疗后,观察组盆腔痛、痛经、性交痛和疼痛总分均低于对照组（P〈0.05）;两组患者治疗前性激素水平和子宫内膜厚度无明显差异（P〉0.05）,治疗后,观察组FSH、E2和子宫内膜厚度均低于对照组（P〈0.05）;两组患者治疗前细胞因子水平无明显差异（P〉0.05）,治疗后,观察组IL-18和TNF-α水平低于对照组（P〈0.05）.结论 GnRh-a治疗可以通过抑制血清中细胞炎症因子的表达,稳定性激素水平,进而发挥其临床治疗效果.

Objective To investigate the effect of GnRH-a on the levels of FSH,E2,IL-18 and TNF- alpha in endometriosis patients. Methods From January 2014 to January 2017,patients with EM treated by non operative as the observation object,according to the treatment methods were divided into control group and observation group,the observation group was treated with GnRh-a,the control group was given mifepristone treatment,two groups were treated for 3-6 months. The pain score,sex hormone level,cytokine level,endometrial thickness and sexual life quality of the two groups were observed before and after treatment. Results There was no difference in the pain score before treatment in both groups（P〉0.05）,the pelvic pain,dysmenorrhea,dyspareunia and pain scores in the observation group after treatment were lower than that of control group（P〈0.05）. In the two groups before treatment in patients with sex hormone levels and endometrial thickness difference（P〉0.05）,after treatment,FSH,E2,and endometrial thickness of observation group were lower than control group（P〈0.05）. There was no difference in the cell factor level before treatment in both groups（P〉0.05）,after treatment,observation group of TNF and IL-18 - alpha level was lower than the control group（P〈0.05）. Conclusion GnRh-a treatment can inhibit the expression of cell inflammatory cytokines in serum,stabilize sex hormone levels, which exerts its clinical therapeutic effect.