维生素E治疗子宫内膜不典型增生的效果观察及机制研究

Effect observation and mechanism study of vitamin E in the treatment of endometrial atypical hyperplasia

目的探讨维生素E治疗子宫内膜不典型增生(endometrial atypical hyperplasia,EAH)的效果及机制。方法将2019年2月至2021年11月在重庆大学附属三峡医院收治的100例EAH患者按随机数字表法分为两组,每组50例,对照组予以高效孕激素醋酸甲羟孕酮口服治疗,研究组在对照组的基础上予以维生素E口服治疗,治疗期间随访患者子宫内膜厚度、药物不良反应,每3个月行诊断性刮宫了解子宫内膜病变情况,比较两组的治疗效果,Western blot检测治疗前后环氧合酶-2(cyclooxygenase-2,COX-2)的表达变化。结果治疗后研究组的子宫内膜厚度明显降低,与对照组相比,差异有统计学意义(P<0.05);研究组有效率较对照组有所提高,但差异无统计学意义(P>0.05);两组患者的药物不良反应率的差异无统计学意义(P>0.05)。治疗后COX-2蛋白的表达在研究组中明显降低(P<0.05)。结论在逆转子宫内膜病变上,维生素E能增强高效孕激素的作用,有利于EAH的治疗,其机制可能与维生素E能够下调组织细胞中COX-2的表达水平有关。

Objective To investigate the role and mechanism of vitamin E in the treatment of endometrial atypical hyperplasia(EAH).Methods 100 cases of EAH admitted to Chongqing University Three Gorges Hospital from February 2019 to November 2021,were divided into two groups according to random number table method,with 50 cases in each group,the control group was given high-efficiency progesterone medroxyprogesterone acetate oral treatment,while the study group was given oral vitamin E on the basis of the control group.During the treatment,the endometrial thickness and adverse drug reactions of the patients were followed up,and diagnostic curettage was performed every 3 months to understand endometrial lesions.The treatment effects of the two groups were compared,the expression of cyclooxygenase-2(COX-2)was detected by Western blot before and after treatment.Results After treatment,the endometrial thickness of the study group was significantly reduced,compared with the control group,the difference was statistically significant(P<0.05);the effective rate of the study group was higher than that of the control group,but the difference was not statistically significant(P>0.05).There was no statistically significant difference in the rate of adverse drug reactions between the two groups(P>0.05).The expression of COX-2 protein was significantly decreased in the study group after treatment(P<0.05).Conclusion In reversing endometrial lesions,vitamin E can enhances the effect of highly effective progesterone,which is beneficial to the treatment of EAH,the mechanism may be related to the fact that vitamin E can down-regulate the expression level of COX-2 in tissue cells.