GnRH-α联合LNG-IUS对子宫内膜异位症术后患者血清ENA-78及MCP-1水平的影响

The effect of co-treatment with GnRH-αand LNG-IUS on serum ENA-78 and MCP-1 levels in post-operative patients with endometriosis

目的分析子宫内膜异位症术后患者经促性腺激素释放激素激动剂(GnRH-α)联合左炔诺孕酮宫内缓释系统(LNG-IUS)治疗与血清中性粒细胞活化肽78(ENA-78)和人单核细胞趋化蛋白-1(MCP-1)水平的关系.方法回顾性分析了140例子宫内膜异位症(EM)术后患者临床资料并分为A组(术后单纯应用GnRH-α)40例、B组(术后单纯应用LNG-IUS)40例、C组(术后联合应用GnRH-α+LNG-IUS)30例、D组(单纯接受腹腔镜手术)30例.分别于术后第6个月监测各组血清ENA-78和MCP-1水平的变化情况.结果治疗后,A、B、C三组ENA-78和MCP-1水平均较D组明显下降(P值均<0.05),其中C组与B组的ENA-78水平、C组与A组的MCP-1水平差异亦具有统计学意义(P值均<0.05),A、B两组血清ENA-78差异具有统计学意义(P<0.05),但A、B两组MCP-1水平相比较,差异无统计学意义(P>0.05);并且通过进一步分析,观察到血清ENA-78、MCP-1水平在A、B及C中均呈正相关关系.结论通过治疗后血清中中性粒细胞活化肽78(ENA-78)和人单核细胞趋化蛋白-1(MCP-1)水平的变化评估得知,EM术后患者联合使用GnRH-α和LNG-IUS优于各自单独治疗,且二者联合呈协同作用,显著降低患者血清ENA-78和MCP-1水平.这可为临床治疗提供可靠的理论基础.

Objective To analysis the correlation between serum ENA-78 and MCP-1 levels after co-treatment of Gonadotropin-releasing hormone agonist(GnRH-α)and Levonorgestrel intrauterine sustained release system(LNG-IUS)in post-operative patients with endometriosis.Methods 140 patients with endometriosis were analyzed retrospectively,which divided into group A(post-operative application of simple GnRH-α),group B(post-operative application of simple LNG-IUS),group C(post-operative application of GnRH-αand LNG-IUS)and group D(just accept laparoscopic surgery).The changes of serum ENA-78 and MCP-1 levels in each group were monitored at the 6 th postoperative month.Results The serum ENA-78 and MCP-1 levels in the group A,B and C were apparently decreased compared with the group D(P value were all<0.05)after treatment,and difference between the group C and the group B in ENA-78,difference between the group C and group A in MCP-1 were statistically significantly(P<0.05),however,no differences exist between the group A and B in MCP-1 levels(P>0.05),but different in ENA-78(P<0.05).Additionally,further analysis revealed the positive correlation between serum ENA-78 and MCP-1 levels in the group A,B,and C.Conclusion combined administration of GnRH-αand LNG-IUS were better than single treatment and shows a synergistic effect in post-operative patients with endometriosis,significantly reducing the serum ENA-78 and MCP-1 levels in patients.This can provide a reliable theoretical basis for clinical treatment.