注射用醋酸亮丙瑞林微球联合米非司酮片对子宫肌瘤患者血清性激素、ER、Bcl-2水平的影响

Effect of Injectable Leuprolide Acetate Microspheres Combined with Mifepristone Tablets on Serum Sex Hormone,ER and Bcl-2 Levels in Patients with Uterine Fibroids

目的:探究注射用醋酸亮丙瑞林微球联合米非司酮片对子宫肌瘤(UM)患者血清性激素、雌激素受体(ER)、B淋巴细胞瘤-2(Bcl-2)水平的影响。方法:前瞻性选取2020年1月—2022年1月西华县人民医院UM患者116例作为研究对象,以随机数表法分为联合组和常规组,每组各58例。常规组患者予以米非司酮片,联合组患者基于常规组联合注射用醋酸亮丙瑞林微球。比较两组患者临床疗效、临床症状改善情况、性激素水平[卵泡刺激素(FSH)、孕酮(P)、雌二醇(E_(2))、黄体生成素(LH)]、血清指标[基质金属蛋白酶组织抑制因子(TIMPs)、肿瘤抑制蛋白酶和张力蛋白同源物(PTEN)、ER、Bcl-2]及不良反应发生情况。结果:联合组患者总有效率高于常规组,差异有统计学意义(χ^(2)=4.208,P<0.05);治疗后,联合组患者月经量减少,肌瘤、子宫体积缩小,差异有统计学意义(t=8.213、7.889、6.838,P<0.05);治疗后,联合组患者FSH、P、E2、LH水平低于常规组,差异有统计学意义(t=9.891、6.955、8.684、4.848,P<0.05);治疗后,联合组患者TIMPs、PTEN水平较高,ER、Bcl-2水平较低,差异有统计学意义(t=4.198、6.915、4.104、5.153,P<0.05);联合组患者不良反应发生率与常规组患者比较,差异无统计学意义(χ^(2)=1.75,P>0.05)。结论:注射用醋酸亮丙瑞林微球联合米非司酮片应用于UM患者具有显著治疗效果,能改善患者临床症状,调节性激素水平,调控相关侵袭基因蛋白表达,且安全性高。

Objective:To investigate the effects of injectable leuprolide acetate microspheres combined with mifepristone tablets on serum sex hormone,estrogen receptor(ER),and B lymphocytoma-2(Bcl-2)levels in patients with uterine fibroids(UM).Methods:116 cases of UM patients in the hospital from January 2020 to January 2022 were selected for the study and were divided into combined group and conventional group by random number table method,with 58 cases in each group.The conventional group was given mifepristone tablets and the combined group was based on the conventional group combined with injectable leuprolide acetate microspheres.Clinical efficacy,improvement of clinical symptoms,sex hormone levels(follicle-stimulating hormone[FSH],progesterone[P],estradiol[E_(2)],luteinizing hormone[LH]),serum indexes(tissue inhibitory factors of matrix metalloproteinases[TIMPs],tumor suppressor proteases and tensin homologues[PTENs],ER,and Bcl-2),and adverse reactions were compared between the two groups.Results:The total effective rate of the combined group was 91.38%,which was higher than the 77.59%of the conventional group,and the difference was statistically significant(χ^(2)=4.208,P<0.05).Compared with the conventional group,the combined group showed a decrease in menstrual flow and a reduction in the size of leiomyoma and uterus after treatment,and the difference was statistically significant(t=8.213,7.889,6.838,P<0.05).After treatment,the levels of FSH,P,E2,and LH were lower in the combined group than in the conventional group,and the difference was statistically significant(t=9.891,6.955,8.684,4.848,P<0.05).Compared with the conventional group after treatment,the combined group had higher levels of TIMPs and PTEN and lower levels of ER and Bcl-2,and the difference was statistically significant(t=4.198,6.915,4.104,5.153,P<0.05).The incidence of adverse reactions in the combined group was 5.17%,which was not statistically significant when compared with 12.07%in the conventional group(χ^(2)=1.75,P>0.05).Conclusion:Leuprolide acetate microspheres for injection combined with mifepristone tablets have significant therapeutic effects in UM,which can improve patients’clinical symptoms,regulate the level of sex hormones,regulate the expression of relevant invasive gene proteins,and have high safety.