促性腺激素释放激素激动剂对子宫内膜异位症生育期患者炎性因子及CXCR-4、SDF-1的影响

The effects of GnRH-a on inflammatory factors,CXCR-4 and SDF-1 of reproductive stage patients with endometriosis

目的研究促性腺激素释放激素激动剂(Gn RH-a)对子宫内膜异位症(EMs)生育期患者炎性因子及CXCR-4、SDF-1的影响。方法选取2014年7月至2017年6月我院EMs生育期患者136例,依照随机数字表法分为试验组与对照组各68例。对照组行腹腔镜治疗,试验组行腹腔镜+Gn RH-a治疗。比较两组治疗前及治疗6个月后FSH、LH、E2等性激素水平;hs-CRP、IL-8、TNF-α等炎性因子水平;CXCR-4、SDF-1等肿瘤因子水平;治疗后1年输卵管畅通、妊娠及复发情况。结果治疗6个月后,两组FSH、LH、E2、hs-CRP、IL-8、TNF-α、CXCR-4、SDF-1均降低,且试验组指标均低于对照组(P<0.05)。治疗1年后,试验组输卵管畅通率、妊娠率均高于对照组,复发率低于对照组(P<0.05)。结论Gn RH-a可诱导EMs细胞凋亡,促进EMs病灶萎缩、退化,抑制分泌性激素、炎性因子及CXCR-4、SDF-1,提高EMs生育期患者妊娠率,降低其复发率。

Objective To investigate the effects of GnRH-a on inflammatory factors,CXCR-4 and SDF-1 of reproductive stage patients with endometriosis(EMs).Methods One hundred and thirty-six reproductive stage patients with EMs admitted to our hospital from July 2014 to June 2017 were included in this study.The patients were divided into experimental or control group using random number table method,68 in each group.Laparoscope treatment was given to patients in the control group while laparoscope treatment combined with GnRH-a was given to the experimental group.Before and after 6 months of treatment,levels of sex hormones including FSH,LH and E2,inflammatory factors including hs-CRP,IL-8 and TNF-α,and tumor factors including CXCR-4 and SDF-1 were compared.Status of fallopian tube patency,pregnancy and recurrence within 1 year after treatment were also observed.Results After 6 months of treatment,the levels of FSH,LH,E2,hs-CRP,IL-8,TNF-α,CXCR-4 and SDF-1 were decreased in both groups and these indicators in the experimental group were lower than those in the control group(P<0.05).After 1 year of treatment,rate of fallopian tube patency and pregnancy rate was higher and recurrence rate was lower in the experimental group than those in the control group(P<0.05).Conclusion GnRH-a can induce the EMs cell apoptosis,promote the EMs lesion atrophy and degradation,inhibit the secretion of sex hormones,inflammatory factors,and tumor factors,improve the pregnancy rate of the patients and reduce the recurrence rate.