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注射用醋酸亮丙瑞林微球联合腹腔镜对子宫内膜异位症患者血清TIMP-1 MMP-9水平及受孕率的影响 预览

Effects of Leuprolide Acetate Microspheres Combined with Laparoscopy on Serum TIMP-1 MMP-9 Levels and Conception Rate in Patients with Endometriosis
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摘要 目的:探讨注射用醋酸亮丙瑞林微球联合腹腔镜对子宫内膜异位症患者血清基质金属蛋白酶-9(MMP-9)及基质金属蛋白酶抑制剂-1(TIMP-1)水平、受孕率的影响。方法:选取我院子宫内膜异位症患者98例(2014年12月至2017年3月),根据治疗方案分为对照组(n=49)与研究组(n=49)。对照组采取腹腔镜保守手术,研究组于对照组基础上加用醋酸亮丙瑞林微球(1次/4周,共注射6次)。统计两组临床疗效、治疗前后性激素指标[黄体生成素(LH)、孕激素(P)、卵泡刺激素(FSH)、雌二醇(E2)]水平、血清MMP-9及TIMP-1水平、MMP-9/TIMP-1、治疗前及治疗后1个月雌激素状态所致绝经症状评分(Kupperman)及盆腔疼痛程度分值(VAS),并随访9~12个月,统计两组受孕率。结果:①临床疗效:研究组总有效率93.88%(46/49)高于对照组79.59%(39/49)(P<0.05);②性激素指标:两组治疗后血清LH、P、FSH、E2水平低于治疗前,且研究组低于对照组(P<0.05);③血清MMP-9及TIMP-1:两组治疗后血清MMP-9及TIMP-1水平及MMP-9/TIMP-1较治疗前降低,且研究组低于对照组(P<0.05);④Kupperman及VAS分值:两组治疗后1个月Kupperman及VAS分值较治疗前降低,且研究组低于对照组(P<0.05);⑤受孕率:治疗后9个月、12个月研究组受孕率(36.73%、51.02%)高于对照组(18.37%、28.57%)(P<0.05)(P<0.05)。结论:采取注射用醋酸亮丙瑞林微球联合腹腔镜治疗子宫内膜异位症,可有效改善其血清性激素含量,降低血清MMP-9及TIMP-1水平,调节MMP-9/TIMP-1平衡,缓解临床症状及疼痛感,改善疾病整体治疗效果,且利于提高受孕率,对改善患者预后效果具有一定积极意义。 Objective: To investigate the effect of pregnancy rate, serum matrix metalloproteinase-9 (MMP-9) and matrix metalloproteinase inhibitor-1 (TIMP-1) levels in endometriosis patients who were treated with leuprolide acetate microspheres and laparoscopy. Methods: 98 patients with endometriosis in our hospital (From December 2014 to March 2017) were randomly divided into the control group (n=49) and the study group (n=49) according to the treatment plan. The control group underwent laparoscopic conservative surgery. The study group was given leuprolide acetate microspheres on the basis of the control group (once / 4 weeks, a total of 6 injections). The clinical efficacy of the two groups, the sex hormone indicators before and after treatment [Luteinizing hormone (LH), progesterone (P), follicle stimulating hormone (FSH), estradiol (E2)] levels, serum MMP-9 and TIMP-1 levels, MMP-9/TIMP-1, pre-treatment and 1 month post-treatment estrogen status scores (Kupperman) and pelvic pain scores (VAS), followed up for 9 to 12 months, statistics of pregnancy rates were compared. Results:①Clinical efficacy: The total effective rate of the study group was 93.88%(46/49) higher than that of the control group (79.59%(39/49)(P<0.05);②Sex hormone indicators: serum LH, P after treatment The levels of FSH and E2 were lower than those before treatment, and the study group was lower than the control group (P<0.05).③Serum MMP-9 and TIMP-1: serum MMP-9 and TIMP-1 levels and MMP after treatment -9/TIMP-1 was lower than before treatment, and the study group was lower than the control group (P<0.05);⑤Kupperman and VAS scores: Kupperman and VAS scores were lower than those before treatment in the two groups after treatment. The study group was lower than the control group (P<0.05);⑥Pregnancy rate: 9 months and 12 months after treatment, the pregnancy rate of the study group (36.73%, 51.02%) was higher than that of the control group (18.37%, 28.57%).(P<0.05). Conclusion: The use of leuprolide acetate microspheres combined with laparosco
作者 章琼 滕慧 胡玉利 嵇晓红 吴元赭 郝群 ZHANG Qiong;TENG Hui;HU Yuli(General Hospital of Eastern War Zone of PLA, Jiangsu Nanjing 210002, China)
出处 《河北医学》 CAS 2019年第5期726-732,共7页 Hebei Medicine
基金 江苏省六大人才高峰资助项目,(编号:2015-WSW-045).
关键词 醋酸亮丙瑞林微球 腹腔镜 子宫内膜异位症 TIMP-1 MMP-9 受孕率 Leuprolide acetate microspheres Laparoscopy Endometriosis TIMP-1 MMP-9 Conception rate
作者简介 通讯作者:郝群.
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