醋酸戈舍瑞林缓释植入剂在子宫内膜异位囊肿腹腔镜术后患者中的应用研究

An Application Study of Goserelin Acetate Sustained-release Depot in the Patients with Endometriosis Cyst After Laparoscopic Surgery

目的研究醋酸戈舍瑞林缓释植入剂(goserelin acetate sustained-release depot,GAS-RD)在子宫内膜异位囊肿(endometriosis cyst,EMC)腹腔镜术后患者中的应用效果。方法选择2012年1月至2014年12月在河南省中医院治疗的EMC患者78例,按照随机数字表法分为GAS-RD组(n=39)与孕三烯酮组(n=39)。两组均行腹腔镜EMC剥除术,术后,孕三烯酮组以孕三烯酮治疗,GAS-RD组以GAS-RD治疗。观察两组治疗前及术后6个月血清促卵泡激素(FSH)、促黄体生成素(LH)、雌二醇(E2)、催乳素(PRL)水平;血清糖类抗原125(CA125)、血管内皮细胞生长因子(VEGF)、丝裂原活化蛋白激酶(MAPK)水平;治疗后受孕情况、复发率及不良反应。结果术后6个月,GAS-RD组血清FSH、LH、E2、PRL、CA125、VEGF、MAPK水平均低于孕三烯酮组,差异有统计学意义(P<0.05)。GAS-RD组总有效率(89.74%)高于孕三烯酮组(69.23%),差异有统计学意义(P<0.05)。GASRD组受孕率(41.03%)高于孕三烯酮组(20.51%),复发率(15.38%)低于孕三烯酮组(38.46%),差异均有统计学意义(P<0.05)。治疗期内,两组患者均无明显不良反应。结论 GAS-RD可有效降低EMC腹腔镜术后患者雌性激素及肿瘤因子水平,且受孕率高,复发率低,具有临床应用价值。

Objective To study the application effect of Goserelin Acetate Sustained Release Depot （GAS- RD） in the patients with endometriosis cyst （EMC） after laparoscopic surgery. Methods A total of 78 EMC cases treated in Henan Province Hospital of TCM from January of 2012 to December of 2014 were selected and divided into the GAS-RD group （n= 39） and gestrinone group （n= 39） according to the random number table. After all the patients of both groups underwent the operation of laparoscopic EMC stripping, the gestrinone group were treated with gestrinone and the GAS-RD group was given GA^RD. The levels of serum follicle stimulating hormone （FSH）, luteinizing hormone （LH）, Estradiol 2 （E2）, Prolactin （PRL）, carbohydrate antigen125 （CA125）, vascular endothelial growth factor （VEGF）, rnitogen activated protein kinase （MAPK） in the two groups were observed and compared before operation and 6 months after operation respectively. The pregnancy, recurrence rate and adverse reaction after treatment were also observed and compared. Results The levels of FSH, LH, E2, PRL, CA125, VEGF and MAPK in the GAS-RD group were significantly lower than those in the gestrinone group 6 months after operation （P〈0.05）. The total effective rate of the GAS-RD group （89. 74%） was significantly higher than that of the gestrinone group （69.23%） （P〈0.05）. The Pregnancy rate of the GAS-RD group （41.03%） was significantly higher than that of the gestrinone group （20.51 %）. The recurrence rate of the GAS- RD Group （15.38% ） was significantly lower than that of that of the gestrinone group （38.46 % ） （P〈0.05）. There were no obvious adverse reaction during the treatment period in both groups. Conclusion GAS-RD can effectively reduce the levels of estrogen and tumor factors with high fertility rate and low recurrence rate after laparoscopic surgery in the patients with EMC, so it is of value in the clinical application.