雌-孕激素序贯疗法对药物流产后出血患者卵巢功能和血管生成调节因子的影响

Effects of sequential therapy with estrogen-progestin on ovarian function and angiogenesis regulators in patients with hemorrhage after drug abortion

目的探讨雌-孕激素序贯疗法对药物流产后出血患者卵巢功能和血管生成调节因子的影响。方法 98例药物流产后出血患者,根据随机数字表法分为对照组和研究组,每组49例。对照组给予常规止血、抗感染治疗,研究组给予雌-孕激素序贯疗法治疗。比较两组患者临床疗效;比较两组患者治疗前、治疗7 d后卵巢功能指标[雌二醇(E2)、孕酮(P)]水平及血管生成调节因子指标[血管内皮生长因子(VEGF)、血管生成素-1(Ang-1)、血管生成素-2(Ang-2)]水平;比较两组患者不良反应发生情况。结果研究组治疗总有效率为97.96%,高于对照组的79.59%,差异具有统计学意义(P<0.05)。治疗前,两组患者的E2、P水平比较,差异均无统计学意义(P>0.05);治疗7 d后,两组患者的E2水平均较本组治疗前升高, P水平均较本组治疗前降低;且研究组E2水平(76.24±10.25)pmol/L高于对照组的(47.65±9.71)pmol/L, P水平(3.47±0.91)nmol/L低于对照组的(4.53±0.87)nmol/L,差异均具有统计学意义(P<0.05)。治疗前,两组患者的VEGF、Ang-1、Ang-2水平比较,差异均无统计学意义(P>0.05);治疗7 d后,两组患者的VEGF、Ang-1、Ang-2水平均较本组治疗前降低,且研究组降低程度优于对照组,差异均具有统计学意义(P<0.05)。研究组不良反应发生率为18.37%,与对照组的14.29%比较,差异无统计学意义(P>0.05)。结论雌-孕激素序贯疗法对药物流产后出血患者疗效确切,可有效改善患者卵巢功能、血管生成调节因子,且不增加不良反应发生率。

Objective To discuss the effect of sequential therapy with estrogen-progestin on ovarian function and angiogenesis regulators in patients with hemorrhage after drug abortion.Methods A total of 98 patients with hemorrhage after drug abortion were divided by random number table method into control group and research group,with 49 cases in each group.The control group received conventional hemostasis and antiinfective therapy,and the research group received sequential estrogen-progestin therapy.Comparison were made on clinical efficacy,ovarian function index[estradiol(E2),progestin(P)]and angiogenesis regulator index[vascular endothelial growth factor(VEGF),angiopoietin-1(Ang-1),angiopoietin-2(Ang-2)]before treatment and 7 d after treatment,and occurrence of adverse reactions between the two groups.Results The research group had higher total effective rate after treatment as 97.96%than 79.59%in the control group,and the difference was statistically significant(P<0.05).Before treatment,both groups had no statistically significant difference in E2 and P(P>0.05).After 7 d of treatment,both groups had higher E2 than that before treatment,and lower P than that before treatment.The research group had higher E2 as(76.24±10.25)pmol/L than(47.65±9.71)pmol/L in the control group,and lower P as(3.47±0.91)nmol/L than(4.53±0.87)nmol/L in the control group.Their difference was statistically significant(P<0.05).Before treatment,both groups had no statistically significant difference in VEGF,Ang-1 and Ang-2(P>0.05).After 7 d of treatment,both groups had lower VEGF,Ang-1 and Ang-2 than those before treatment,and the research group had better decline degree than the control group.Their difference was statistically significant(P<0.05).The research group had no statistically significant difference in incidence of adverse reactions as 18.37%,comparing with 14.29%in the control group(P>0.05).Conclusion Sequential therapy with estrogen-progestin shows affirmative efficacy for patients with hemorrhage after drug abortion,and it can effectively improve ovarian function and angiogenesis regulators without increasing incidence of adverse reactions.