雌二醇片/雌二醇地屈孕酮片周期治疗与连续治疗对卵巢早衰患者炎症指标、激素和血脂水平的影响

Effects of Cyclic and Continuous Treatment with Estradiol Tablets/Estradiol and Dydrogesterone Tablets on Inflammatory Markers,Hormones and Lipid Levels in Patients with Premature Ovarian Failure

目的:探讨雌二醇片/雌二醇地屈孕酮片周期治疗与连续治疗对卵巢早衰(POF)患者血清炎症指标、激素和血脂水平的影响。方法:采用随机抽签法将2019年3月—2022年2月在宜春市第二人民医院进行治疗的70例POF患者分为对照组和观察组,每组35例。两组均给予雌二醇片/雌二醇地屈孕酮片,观察组进行周期治疗,对照组进行连续治疗。比较两组治疗前后的性激素[血清雌二醇(E_(2))、卵泡刺激素(FSH)、促黄体生成素(LH)]、血脂[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)]、血清炎症指标[肿瘤坏死因子-α(TNF-α)、白细胞介素-21(IL-21)、白细胞介素-1β(IL-1β)]水平及子宫内膜厚度,比较两组不良反应发生率。结果:治疗后,两组的血清FSH、LH、TC、TG、LDL-C、TNF-α及IL-21均较治疗前有所降低,两组E_(2)、HDL-C、IL-1β均较治疗前有所提高,差异均有统计学意义(P<0.05),但上述指标两组组间比较,差异均无统计学意义(P>0.05)。治疗后,两组子宫内膜厚度均较治疗前增厚,且观察组子宫内膜厚度明显较对照组更厚,差异均有统计学意义(P<0.05)。观察组不良反应总发生率(5.71%)低于对照组(22.86%),差异有统计学意义(P<0.05)。结论:给予POF患者雌二醇片/雌二醇地屈孕酮片周期治疗和连续治疗均能改善性激素及血脂水平,能有效缓解炎症;周期治疗在改善POF患者子宫内膜厚度及降低不良反应发生率方面效果更佳。

Objective:To explore the effects of cyclic and continuous treatment with Estradiol Tablets/Estradiol and Dydrogesterone Tablets on inflammatory markers,hormones and lipid levels in patients with premature ovarian failure(POF).Method:A total of 70 patients with POF who were treated in the Second People's Hospital of Yichun from March 2019 to February 2022 were divided into the control group and the observation group by random lottery method,with 35 cases in each group.Both groups were given Estradiol Tablets/Estradiol and Dydrogesterone Tablets,the observation group received cycle treatment,while the control group received continuous treatment.The levels of sex hormones[serum estradiol(E_(2)),follicle stimulating hormone(FSH),luteinizing hormone(LH)],blood lipids[total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C)],and serum inflammatory indicators[tumor necrosis factor-α(TNF-α),interleukin-21(IL-21),interleukin-1β(IL-1β)]and endometrium thickness were compared between the two groups before and after treatment.The incidence of adverse reactions was compared between the two groups.Result:After treatment,the serum FSH,LH,TC,TG,LDL-C,TNF-αand IL-21 of the two groups were lower than those before treatment,and the E_(2),HDL-C and IL-1βof the two groups were higher than those before treatment,the differences were statistically significant(P<0.05),but there were no statistically significant differences of the above indicators between the two groups(P>0.05).After treatment,the endometrium thickness of the two groups were thicker than those before treatment,and the endometrium thickness of the observation group was significantly thicker than that of the control group,the differences were statistically significant(P<0.05).The total incidence of adverse reactions in the observation group(5.71%)was lower than that in the control group(22.86%),the difference was statistically significant(P<0.05).Conclusion:Cyclic and continuous treatment with Estradiol Tablets/Estradiol and Dydrogesterone Tablets in the patients with POF can improve the levels of sex hormones and blood lipids,and effectively relieve inflammation;cyclic treatment has a better effect on improving endometrium thickness and reducing the incidence of adverse reactions in patients with POF.