地诺孕素与促性腺激素释放激素激动剂类药物治疗对子宫内膜异位症手术患者血清糖类抗原125、骨密度、雌二醇和肿块大小的影响

Effect of denorgestrel and GnRh-a drugs on serum CA125,bone mineral density,estradiol and mass size in endometriosis patients undergoing surgery

目的探讨地诺孕素与促性腺激素释放激素激动剂(GnRh-a)类药物治疗对子宫内膜异位症手术患者血清糖类抗原125(CA125)、骨密度和雌二醇(E_(2))的影响。方法选取2019年1月至2020年12月广西医科大学附属武鸣医院诊治的96例子宫内膜异位症患者作为研究对象。采用简单随机分组将其分为观察组(n=48)和对照组(n=48)。对照组行GnRh-a类药物注射治疗,观察组行地诺孕素治疗,持续治疗3个月。分别于术前、治疗后1个月、治疗后3个月比较两组的中文版COX痛经症状评分量表(CMSS)评分、血清CA125、性激素[E_(2)和卵泡刺激素(FSH)]、骨密度和肿块最大直径;比较两组失眠、情绪波动和阴道不规则出血等不良反应的发生情况。结果治疗后1个月、治疗后3个月,观察组CMSS评分低于对照组,血清CA125水平低于对照组,血清性激素(E_(2)和FSH)水平高于对照组,骨密度大于对照组,差异具有统计学意义(P<0.05);两组肿块最大直径均小于术前,且观察组小于对照组,差异具有统计学意义(P<0.05);治疗后两组失眠、情绪波动和阴道不规则出血等不良反应发生情况比较,差异无统计学意义(P>0.05)。结论相比于GnRh-a类药物,地诺孕素治疗对子宫内膜异位症手术患者的临床疗效更为显著,可有效降低CA125水平,改善E_(2)水平,对骨密度损害影响甚小。

Objective To investigate the effects of dienogest and gonadotropin-releasing hormone agonist(GnRh-a)drugs on serum carbohydrate antigen 125(CA125),bone mineral density and estradiol(E_(2))in endometriosis patients undergoing surgery.Methods 96 patients with endometriosis diagnosed and treated in Wuming Hospital Affiliated to Guangxi Medical University from January 2019 to December 2020 were selected as the research objects an they were randomly divided into observation group(n=48)and control group(n=48).The control group was injected with GnRH-a drugs,and the observation group was treated with dienogest,both were treated for 3 months.CMSS score,serum CA125,sex hormones[E_(2),follicle stimulating hormone(FSH)],bone mineral density and maximum mass diameter were compared between the two groups before treatment,1 month and 3 months after treatment.The adverse reactions such as insomnia,mood swings and irregular vaginal bleeding were compared between the two groups.Results 1 month and 3 months after treatment,the scores of CMSS in the observation group were lower than those in the control group(P<0.05);serum CA125 in the observation group was lower than that in the control group(P<0.05);the serum sex hormones(E_(2) and FSH)in the observation group were higher than those in the control group(P<0.05);the bone density was higher than that of the control group(P<0.05).The maximum diameter of the mass in both groups were smaller than before treatment,and that in the observation group was smaller than that in the control group(P<0.05).There was no significant difference between the observation group and the control group in terms of insomnia,mood swings,irregular vaginal bleeding and other adverse reactions after treatment(P>0.05).Conclusions Compared with GnRh-a drugs,dienogest has a significant clinical effect on patients undergoing endometriosis surgery,which can effectively reduce CA125 level and improve E_(2) level,and has little effect on bone density damage.