地屈孕酮结合芳香化酶抑制剂治疗子宫内膜异位症的临床效果及对血清CA125、MMP-3、VEGF的影响

Clinical effects of dydrogesterone combined with aromataseinhibitor for treating patients with endometriosis and its influence on serum levels of CA125,MMP-3 and VEGF

目的:探讨地屈孕酮结合芳香化酶抑制剂治疗子宫内膜异位症的临床价值。方法:选取2015年10月-2017年10月本院收治的子宫内膜异位症患者104例为研究对象,以随机数字表法分为对照组52例,观察组52例。对照组给予地屈孕酮治疗,观察组在对照组基础上加用芳香化酶抑制剂来曲唑治疗,观察两组治疗效果,治疗前、治疗6个月后血清糖类抗原125(CA125)、基质金属蛋白酶-3(MMP-3)、血管内皮生长因子(VEGF)及性激素水平变化,用药期间不良反应发生情况。结果:观察组治疗总有效率(94.2%)高于对照组(80.8%)(P <0.05);治疗前两组血清CA125、MMP-3、VEGF及性激素水平无统计学差异(P>0.05),治疗后两组均有下降,且观察组各项水平均低于同期对照组(P<0.05);用药期间不良反应发生率观察组(17.3%)与对照组(15.4%)比较无差异(P>0.05)。结论:地屈孕酮结合芳香化酶抑制剂治疗子宫内膜异位症,疗效显著,可明显降低血清CA125、MMP-3、VEGF水平,改善性激素状况,且安全性较高。

Objective To investigate the clinical value of dydrogesterone combined with aromataseinhibitor for treating patients with endometriosis. Methods： A total of 104 patients with endometriosis treated in Nanyang central hospital from Oct 2015 to Oct 2017 were selected as study subjects, and all included patients were divided control group and observation group （52 patients in each group） by the random digital table. The patients in control were treated by dydrogesterone, and the patients in observation group were treated letrozole （byaromataseinhibitor） except by dydrogesterone. The effects of treatment, the changes of serum levels of carbohydrate antigen 125 （CA125）, matrix metalloproteinase 3 （MMP 3）, vascular endothelial growth factor （VEGF） and sex hormone of patients in the two groups were observed before treatment and 6 months after treatment. The incidence of adverse reactions during the medication of patients in the two groups were also recorded. Results： The total effective rate of patients in observation group was 94.2 %, which was statistically significant higher than that of patients （80.8%） in control group （ P 〈 0.05）. There were no significant different in serum levels of CA125, MMP 3, VEGF and sex hormone between the two groups before treatment （ P 〉0.05）, but the levels of serum CA125, MMP 3, VEGF and sex hormone of all patients had decrease after treatment. After treatment, the levels of serum CA125, MMP 3, VEGF, follicle stimulating hormone （FSH）, estradiol （E2） and luteinizing hormone （LH） of patients in observation group were statistically significant lower than those of patients in control group （ P 〈0.05）. The incidence of adverse reactions during medication in observation was 17.31%, which had no statistically significant different to that （15.38%） in control group （ P 〉0.05）. Conclusion： The dydrogesterone combined with aromataseinhibitor for treating patients with endometriosis has significant effect, which can significantly reduce the levels of serum CA125, MMP 3, VEGF, can improve the status of sex hormones, and has better safety.