Abstract
[Objective]To observe the application effect of GnRH-a and sequential therapy with dienogest on endometriosis(EMT).[Methods]It was a prospective study,with 102 EMT patients admitted to Anyang People's Hospital from January 2022 to January 2023 as the research subjects.Random sequences were generated using computer randomization,and after allocation concealment,the enrolled patients were divided into a conventional group(51 cases)and a sequential group(51 cases).Both groups of patients underwent surgical treatment,with the conventional group receiving only GnRH-a for postoperative maintenance treatment,and the sequential group receiving gonadotropin releasing hormone agonist(GnRH-a)and sequential dienogest for postoperative maintenance treatment.The hormone levels[estradiol(E2),progesterone(P),follicle stimulating hormone(FSH),luteinizing hormone(LH)],endometrial receptivity[placental protein 14(PP14),galectin-1(Gal-1)expression score,osteopontin(OPN)molecular expression level,endometrial thickness],endometrial neovascularization indicators[vascular endothelial growth factor(VEGF),basic fibroblast growth factor(bFGF),tumor necrosis factor-α(TNF-α),carbohydrate antigen 125(CA125)]and adverse reactions caused by low hormones(night sweats,hot flashes,bone and joint pain,decreased libido,insomnia)were compared between the two groups.[Results]Under different treatment regimens,the E2,P,FSH,and LH levels in the sequential group were 102.33±20.45 pmol/L,0.38±0.11 nmol/L,3.52±0.36 U/L,and 3.41±0.26 U/L,respectively,which were lower than those in the conventional group(117.45±20.36 pmol/L,0.71±0.18 nmol/L,4.41±1.26 U/L,4.35±1.21 U/L),and the difference was statistically significant(t=3.742,11.172,4.850,5.424;P<0.05).The PP14,Gal-1,OPN,and endometrial thickness in the sequential group(25.33±5.25 μg/L,5.41±1.44 score,45.29±10.36 kDa,10.32±2.27 mm)were all higher than those in the conventional group(22.62±5.14 μg/L,4.57±1.52 score,40.36±10.23 kDa,8.33±1.52 mm),and the difference was statistically significant(t=2.634,2.865,2.418,5.202;P<0.05).VEGF,bFGF,TNF-α,and CA125 in the sequential group were 20.36±5.33 pg/mL,10.22±2.45 pg/mL,21.33±5.28 ng/mL,and 30.23±5.16 U/mL,respectively,all lower than the conventional group(23.39±5.34 pg/mL,12.42±3.24 pg/mL,24.19±5.33 ng/mL,33.46±5.37 U/mL),and the difference was statistically significant(t=2.868,3.868,2.722,3.097;P<0.05).The incidence of menopausal adverse reactions caused by low hormones in the sequential group was 3.92%(2/51),lower than that in the conventional group[21.57%(11/51)],and the difference was statistically significant(χ2=7.141;P<0.05).[Conclusion]GnRH-a sequential treatment with dienogest can improve hormone levels and endometrial receptivity in patients with EMT,and has a positive effect on inhibiting endometrial neovascularization and reducing the risk of adverse reactions caused by low hormones.关键词
子宫内膜异位症/促性腺激素释放激素激动剂/地诺孕素/激素水平/子宫内膜受容性Key words
endometriosis/gonadotropin releasing hormone agonists/dienogest/hormone levels/endometrial receptivity分类
医药卫生
