米非司酮联合孕三烯酮治疗子宫内膜异位症对患者卵巢功能、炎性因子及妊娠率影响

Effects of mifepristone combined with gestrinone for treating the patients with endometriosis on their ovarian function,inflammatory factors levels,and pregnancy rate

目的:分析米非司酮联合孕三烯酮治疗对子宫内膜异位症(EMT)对患者卵巢功能、炎性因子及妊娠率的影响。方法:回顾性分析2019年3月-2021年3月于本院进行EMT治疗的128例患者资料。按照治疗方式分为孕三烯酮组(62例,孕三烯酮治疗)和联合组(66例,米非司酮联合孕三烯酮治疗),均在治疗前、治疗6个月观察两组卵巢功能指标促卵泡激素(FSH)、雌激素(E2)、黄体生成素(LH)及孕酮(P)和炎性指标白细胞介素-4(IL-4)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(hs-CRP)及白细胞介素-8(IL-8)、观察不同类型EMT特点、随访治疗6、12个月妊娠结局及不良反应。结果:治疗后,两组卵巢功能指标与炎性因子水平均降低,且联合组低于孕三烯酮组(P<0.05);随访发现,联合组治疗6、12个月的自然妊娠率(47.0%、54.5%)与辅助生殖技术妊娠率(27.3%、37.9%)均高于孕三烯酮组(24.2%、35.5%,12.9%、19.4%)(均P<0.05);不良反应两组(10.6%、6.5%)无差异(P>0.05)。结论:米非司酮联合孕三烯酮治疗对EMT能改善患者炎性因子水平和卵巢功能指标,提升妊娠率,未增加不良反应。

Objective:To analyze the effects of mifepristone combined with gestrinone for treating the patients with en-dometriosis(EMT)on their ovarian function,inflammatory factors levels,and pregnancy rate.Methods:The data of 128 patients with endometriosis who underwent treatment from March 2019 to March 2021 were analyzed retrospec-tively.According to the treatment methods,these patients were divided into control group(62 cases with gestrinone treatment)and study group(66 cases with treatment of mifepristone combined with gestrinone).The levels of follicle stimulating hormone(FSH),estrogen(E2),luteinizing hormone(LH),and the progesterone(P),and the levels of o-varian function indicators,such as interleukin 4(IL-4),tumor necrosis factora(TNF a),hypersensitive C reactive pro-tein(hs-CRP),and interleukin 8(IL-8)of the patients in the two groups before treatment and in 6 months after treat-ment were observed.The characteristics of different types of EMT,the pregnancy outcomes and the adverse reactions in the 6 and 12 months of follow up after treatment of the patients in the two groups were observed.Results:The lev-els of ovarian function indexes and inflammatory factors of the patients in both groups after treatment had decreased significantly,and which of the patients in the study group were significantly lower than those of the patients in the con-trol group(P<0.05).The natural pregnancy rates of the patients in the study group in the 6 and 12 months after treat-ment were 47.0%and 54.5%,respectively,which were significantly higher than those(24.2%and 35.5%)of the pa-tients in the control group.The pregnancy rates after assisted reproductive technology of the patients in the study group in the 6 and 12 months after treatment were 27.3%and 37.9%,which were significantly higher than those(12.9%and 19.4%)of the patients in the control group(all P<0.05).There was no significant difference in the adverse reactions rate(10.6%vs.6.5%)of the patients between the two groups(P>0.05).Conclusion:Mifepristone combined with gestrinone for treating the patients with EMT can improve their levels of inflammatory factors and ovarian function in-dicators,and which can increase their pregnancy rate,without increasing the adverse reactions.