LNG-IUS对子宫内膜息肉电切术病人雌孕激素、炎性因子及子宫内膜组织中IGF-Ⅰ及受体的影响

Effect of LNG-IUS on serum estrogen,progesterone,inflammatory factors,IGF-Ⅰand the related receptors in endometrial tissue of patients with endometrial polyp electrotomy

目的:探究左炔诺孕酮宫内缓释系统(LNG-IUS)对子宫内膜息肉(EP)电切术病人血清雌激素、孕激素、炎性因子、子宫内膜组织胰岛素样生长因子-Ⅰ(IGF-Ⅰ)及受体(IGF-ⅠR)的影响。方法:选取100例子宫内膜息肉病人作为研究对象,采用随机数字表分为观察组和对照组,各50例。对照组在子宫内膜息肉电切术后采取常规口服黄体酮药物治疗,观察组联合放置LNG-IUS治疗。检测2组病人治疗前及治疗6个月雌激素受体(ER)、孕激素受体(PR)、C反应蛋白(CRP)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、IGF-I及IGF-ⅠR表达水平,并分别进行组间比较。结果:随着治疗时间的延长,2组子宫内膜厚度、月经失血图评分法评分均下降,且观察组病人治疗后子宫内膜厚度、月经失血图评分低于对照组(P<0.01)。6个月后,观察组病人的子宫腺皮质、间质内的ER、PR水平降低,且均低于同时点的对照组(P<0.05~P<0.01)。经过治疗,2组病人各项炎症指标、IGF-Ⅰ及受体mRNA相对表达量均降低,且观察组低于对照组(P<0.05~P<0.01)。随访6个月,2组并发症发生率差异无统计学意义(P>0.05)。结论:采用电切术切除子宫内膜息肉后,置入LNG-IUS可以有效降低病人雌孕激素水平,且能缓解术后炎症状态,并降低IGF-Ⅰ水平,值得临床推广。

Objective:To explore the effect of levonorgestrel-releasing intrauterine system(LNG-IUS)on serum estrogen,progesterone,inflammatory factors,and on endometrial tissue insulin-like growth factorⅠ(IGF-Ⅰ)and the related receptor(IGF-ⅠR)in patients undergoing endometrial polyp(EP)electrotomy.Methods:A total of 100 EP patients were selected as the research objects,a random number table was used to divide them into observation group and control group,50 cases in each group.The patients in control group were treated with conventional oral progesterone drugs after EP resection,and the patients in observation group were combined with LNG-IUS treatment after EP resection.The expression levels of serum estrogen receptor(ER),progesterone receptor(PR),C reactive protein(CRP),interleukin-6(IL-6),interleukin-10(IL-10)were examined,IGF-Ⅰand IGF-ⅠR in endometrial tissue were detected and compared between the groups.Results:With the prolongation of treatment,the endometrial thickness and pictorial blood loss assessment chart score in the two groups were significantly reduced,and there were statistically significant differences between the groups at different time points(P<0.01).After 6 months,the levels of ER and PR in the uterine gland cortex and interstitium in the observation group were lower than those in the control group at the same point(P<0.05 to P<0.01).After treatment,the relative expressions of various inflammatory indexes,IGF-Ⅰand IGF-ⅠR mRNA in the two groups were significantly reduced,and they were significantly lower in the observation group than those in the control group(P<0.05 to P<0.01).After 6 months of follow-up,there was no significant difference in the complication occurrence rate between the two groups(P>0.05).Conclusions:After the resection of endometrial polyps,electrotomy,the LNG-IUS implantation can effectively reduce the levels of estrogen and progesterone in patients,relieve postoperative inflammation,and reduce IGF-Ⅰlevel.It is worthy of clinical promotion.