醋酸亮丙瑞林治疗子宫内膜异位症的疗效及对卵巢储备功能的影响

Curative effect of leuprolide acetate in treatment of endometriosis and the influence on ovarian reserve function

目的探究醋酸亮丙瑞林(LA)治疗子宫内膜异位症的疗效及对卵巢储备功能的影响。方法选取2014年9月-2017年1月在遵化市人民医院接受治疗的子宫内膜异位症患者60例为治疗组,在患者月经周期开始的1～5d第1次皮下给予LA治疗,每隔4周给药1次(3.75 mg/次),连续治疗4个月。采用疼痛评分、子宫活动度评分、后陷凹结节大小、附件包块大小对LA疗效进行评估;取患者治疗前后血浆以及30例健康受试者的血浆,采用ELISA对患者治疗前后血清以及健康受试者血清中卵泡生成激素(FSH)、黄体生成激素(LH)、雌二醇(E_2)、孕酮(P)进行评估;记录治疗过程中患者不良反应。结果治疗后患者疼痛评分、子宫活动度评分、后陷凹结节大小、附件包块大小相比于治疗前得到了显著改善(P<0.05);治疗后患血清FSH、LH、E_2、P水平相比于治疗前显著改善(P<0.05);治疗过程出现不良反应(潮热3例、多汗4例、阴道出血2例)。结论 LA治疗子宫内膜异位症表现出较好的效果,且其治疗能够改善患者的卵巢储备功能。

Objective To explore the curative effect of leuprolide acetate（ LA） in treatment of endometriosis and the influence on ovarian reserve function. Methods Sixty patients with endometriosis treated in Zunhua People ＇s Hospital from September 2014 to January2017 were selected as treatment group,the patients were treated by subcutaneous LA during 1-5 days after beginning of menstrual cycle for the first time,then the treatment was repeated every four weeks（ 3. 75 mg per time） for continuous four months. The curative effect of LA was evaluated according to pain score,score of uterine activity,size of hollow nodules,and size of masses of uterine accessories. The plasma samples of patients with endometriosis before and after treatment and 30 healthy women were obtained. ELISA was used to evaluate the levels of serum follicle-stimulating hormone（ FSH）,luteinizing hormone（ LH）,estradiol（ E_2）,and progesterone（ P） in patients with endometriosis before and after treatment and 30 healthy women. The adverse reactions of patients in the course of treatment were recorded. Results Compared with before treatment,pain score,score of uterine activity,size of hollow nodules,and size of masses of uterine accessories,the levels of serum FSH,LH,E_2,and P of patients after treatment were improved significantly（ P〈0. 05）. Three patients with hot flash,four patients with hidrosis,and two patients with colporrhagia were found in the course of treatment. Conclusion The curative effect of LA in treatment of endometriosis is good,LA can improve ovarian reserve function.