不同药物治疗剖宫产子宫切口憩室所致异常子宫出血患者的临床疗效及对其 ER、PR、VEGF表达的影响

Clinical Efficacy and Influence on the Expression of ER,PR and VEGF of Different Drugs in the Treatment of Patients with Abnormal Uterine Bleeding Caused by Diverticulum of Cesarean Section Uterine Incision

目的探究左炔诺孕酮宫内缓释系统(商品名:曼月乐)和短效避孕药屈螺酮炔雌醇片(Ⅱ)(商品名:优思悦)治疗剖宫产子宫切口憩室所致异常子宫出血患者的临床疗效及对其雌激素受体(ER)、孕激素受体(PR)、血管内皮生长因子(VEGF)表达的影响。方法选取2018年12月至2019年12月期间我院收治的剖宫产子宫切口憩室所致异常子宫出血患者60例作为研究对象,采用随机数字表法分为对照组与观察组,各30例。对照组患者给予月经第1天口服复方口服短效避孕药优思悦,观察组患者给予月经第3~7天宫内放置曼月乐。观察两组患者的治疗情况,并比较两组患者治疗1、3、6个月后出血改善情况;比较两组患者治疗前、治疗3个月后、治疗6个月后的ER、PR、VEGF的表达水平变化情况。结果观察组患者未发生曼月乐脱落情况,对照组患者未发生漏服及停药,全部患者均顺利完成参与本次研究。观察组患者治疗1、3、6个月后出血改善情况评分明显高于对照组,差异有统计学意义(P<0.05)。治疗3个月后、治疗6个月后,两组患者ER、PR表达水平均较本组治疗前明显降低,VEGF表达水平均较本组治疗前明显升高,差异均有统计学意义(P<0.05);观察组患者ER、PR表达水平均较对照组降低,VEGF表达水平较对照组升高,差异均有统计学意义(P<0.05)。结论曼月乐和短效避孕药优思悦治疗剖宫产子宫切口憩室所致异常子宫出血患者均能取得显著的临床效果,其作用机制可能是调节ER、PR、VEGF的表达,且曼月乐的用药依从性优于短效避孕药优思悦。

Objective To explore the clinical efficacy and influence on the expression of estrogen receptor(ER),progesterone receptor(PR)and vascular endothelial growth factor(VEGF)of levonorgestrel intrauterine sustained-release system(trade name:Mirena)and the short-acting contraceptive drospirenone and ethinyl estradiol tablets(Ⅱ)(trade name:Yousiyue)in the treatment of patients with abnormal uterine bleeding caused by diverticulum in cesarean Section Uterine Incision.Methods From December 2018 to December 2019,60 patients with abnormal uterine bleeding caused by diverticulum of cesarean section uterine incision were selected as the research objects.The random number table was used to divide the patients into the control group and the observation group,with 30 cases each.Patients in the control group were given oral compound oral short-acting contraceptive Yousiyue on the first day of menstruation,and patients in the observation group were given Mirena in the uterus on the third to seventh days of menstruation.Observe the treatment of the two groups of patients,and compare the improvement of bleeding after 1,3,and 6 months of treatment between the two groups;compare the changes of levels of expression of the ER,PR and VEGF in the two groups before,after 3 months,and after 6 months of treatment.Results None of the patients in the observation group fell off mirena,and none of the patients in the control group missed taking or stopped taking drugs.All the patients in the study completed participating in this study.After 1 month of treatment,3 months of treatment,and 6 months of treatment,the bleeding improvement scores of patients in the observation group were significantly higher than those in the control group after 1,3,and 6 months of treatment,and the difference was statistically significant(P<0.05).After 3 months of treatment and 6 months of treatment,the levels of ER and PR of the two groups of patients were significantly lower than those of the group before treatment,and the levels of VEGF were significantly higher than those of the group before treatment,the difference were statistically significant(P<0.05).The ER and PR levels of the observation group were lower than those of the control group after 3 months of treatment and 6 months of treatment,and the VEGF levels were higher than that of the control group,the differences were statistically significant(P<0.05).Conclusion Both Mirena and the short-acting contraceptive Yousiyue can achieve significant clinical effects in the treatment of patients with abnormal uterine bleeding caused by diverticulum of cesarean section.The mechanism of action may be to regulate the expression of ER,PR and VEGF,and the medication compliance of Mirena is better than that of the short-acting contraceptive Yousiyue.