LNG-IUS联合TCRE治疗对子宫腺肌症患者卵巢功能、MMP指标及相关因子水平的影响

Effects of LNG-IUS combined with TCRE on ovarian function,MMP and related factors in patients with adenomyosis

目的:通过对子宫腺肌病患者在LNG-IUS药物治疗的基础上给予TCRE手术治疗,观察联合治疗方案对患者卵巢功能、MMP指标及相关因子水平的影响。方法:对我院收治的110例2015年10月至2017年10月的子宫腺肌病患者进行病例分析。对照组设为54例患者,观察组设为56例患者。所有患者均在月经周期第4~7天内放置LNG-IUS系统,观察组患者在LNG-IUS的基础上给予TCRE治疗,月经第三日取患者空腹静脉血进行离心处理,测定黄体生成激素(LH)、促卵泡激素(FSH)、雌激素(E2)水平;运用ELISA法检测血清MMP含量检测,包括MMP-2、MMP-3、MMP-9;相关因子检测:VEGF、CA125、IGF-1、Ang-2、PGE2水平并进行比较。结果:(1)治疗前,两组患者LH、FSH、E2水平之间差异无统计学意义(P>0.05);同组治疗前后相比,两组患者LH、FSH、E2水平均显著提高(P<0.05),观察组明显高于对照组,两组之间具有显著性差异(P<0.05);(2)治疗前,两组患者血清MMP-2、MMP-3、MMP-9水平之间差异无统计学意义(P>0.05);同组治疗前后相比,两组患者血清MMP-2、MMP-3、MMP-9水平均显著降低(P<0.05),对照组明显高于观察组,两组之间具有显著性差异(P<0.05);(3)治疗前,两组患者血清VEGF、CA125、IGF-1、Ang-2、PGE2水平之间差异无统计学意义(P>0.05);同组治疗前后相比,两组患者血清VEGF、CA125、IGF-1、Ang-2、PGE2水平均显著降低(P<0.05),观察组患者均明显低于对照组,两组之间具有显著性差异(P<0.05)。结论:对子宫腺肌病患者在LNG-IUS药物治疗的基础上实施TCRE,可以明显改善患者卵巢功能、血清MMP-2、MMP-3、MMP-9以及VEGF、CA125、IGF-1、Ang-2、PGE2水平,表明TCRE联合LNG-IUS药物治疗不仅可以提高疗效,改善患者月经量多,痛经等症状,控制病情发展,还可以通过调节某些因子的表达而起到改善卵巢功能的作用,值得临床上推广应用。

Objective:To observe the effect of combined therapy regimen on ovarian function,MMP and related factors in patients with adenomyosis under the condition of LNG-IUS drug therapy.Methods:110 patients with adenomyosis from October 2015 to October 2017 were retrospectively analyzed and divided into control group and observation group.The control group of 54 patients,observation group of 56 patients.All patients were treated with LNG-IUS system in the 4th to 7th day of the menstrual cycle.The patients in the observation group were treated with TCRE on the basis of LNG-IUS.The fasting venous blood was taken from the third day of menstruation and the luteinizing hormone(LH(MMP-2,MMP-3,MMP-9)were detected by enzyme-linked immunosorbent assay(ELISA).The levels of VEGF,CA125 and IGF-1 were detected by enzymelinked immunosorbent assay(ELISA)Ang-2,PGE2 levels were compared.Results:There was no significant difference in LH,FSH and E2 levels between the two groups before treatment(P> 0.05).After treatment,the levels of LH,FSH and E2 were significantly higher in the two groups compared with those before treatment(P<0.05).(2)Before treatment,the levels of serum MMP-2,MMP-3,MMP-2 and MMP-2 in the two groups were significantly higher than those in the control group(P<0.05)(P<0.05).The levels of MMP-2,MMP-3 and MMP-9 in the serum of the two groups were significantly lower than those before treatment(P<0.05),and there was no significant difference between the two groups(P> 0.05)(P<0.05).(3)Before treatment,serum levels of VEGF,CA125,IGF-1,Ang-2 and PGE2 in the two groups were significantly lower than those in the control group(P<0.05)(P<0.05).The levels of serum VEGF,CA125,IGF-1,Ang-2 and PGE2 in the two groups were significantly lower than those before treatment(P> 0.05)The patients in the observation group were significantly lower than the control group,there was significant difference between the two groups(P<0.05).Conclusion:The levels of serum MMP-2,MMP-3,MMP-9 and VEGF,CA125,IGF-1,Ang-2 and MMP-2 in patients with adenomyosis were treated with TCRE on the basis of LNG-IUS drug therapy.PGE2 level,indicating that TCRE combined with LNG-IUS drug therapy can not only improve the efficacy,improve the patient's menstrual flow,dysmenorrhea and other symptoms,control the progression of the disease,but also by regulating the expression of certain factors play a role in improving ovarian function,worthy of clinical On the promotion and application.