孕三烯酮、米非司酮和GnRHa对有生育需求的重度子宫内膜异位症患者生育能力的影响对比

Comparison of the effects of gestrinone,mifepristone and GnRHa on fertility in patients with severe endometriosis with fertility needs

目的:对比孕三烯酮、米非司酮和促性腺激素释放激素激动剂(GnRHa)对有生育需求的重度子宫内膜异位症患者生育能力的影响。方法:回顾性分析本院136例重度子宫内膜异位症患者的临床资料,术后应用孕三烯酮治疗的有43例,设置为甲组,应用米非司酮的有47例,设置为乙组,应用GnRHa的有46例,设置为丙组。比较术前、术后6个月三组激素水平,治疗效果,妊娠率。结果:术后6个月乙组黄体生成激素(LH)、血清卵泡刺激素(FSH)、雌二醇(E2)水平明显高于甲组、丙组(P<0.05);甲组治疗总有效率略高于乙组、丙组(P>0.05);乙组、丙组1年、2年妊娠率略高于甲组(P>0.05)。结论:孕三烯酮、米非司酮和GnRHa在治疗重度子宫内膜异位症时均能获取较好的效果,三者在激素水平、治疗效果、妊娠率上各有优缺点。

Objective:To compare the effects of gestrinone,mifepristone and GnRHa on fertility in patients with severe endometriosis who have fertility needs.Methods:The clinical data of 136 patients with severe endometriosis in our hospital were retrospectively analyzed.43 patients were treated with gestrinone after operation,and were set to group A.47 patients were treated with mifepristone.In group B,there were 46 cases of GnRHa applied and set to group C.The three groups of hormone levels before and 6 months after operation,treatment effect and pregnancy rate were compared.Results:The levels of LH,FSH,E2 of group B were significantly higher than those of group A and group C at 6 months after operation(P<0.05).The total effective rate of group A treatment was slightly higher than that of group B and group C(P>0.05).The 1-year and the 2-year pregnancy rate of group B and group C were slightly higher than those of group A(P>0.05).Conclusion:Gestrinone,mifepristone and GnRHa can achieve good therapeutic effects in the treatment of severe endometriosis.The three have advantages and disadvantages in hormone level,therapeutic effect and pregnancy rate.