川北医学院学报2026，Vol.41Issue(6)：673-677,5.DOI:10.3969/j.issn.1005-3697.2026.06.006
子宫内膜异位症腹腔镜手术后应用低剂量戈舍瑞林联合地诺孕素对患者雌激素水平、VEGF、MT1-MMP及复发率的影响
Influence of low-dose goserelin combined with dienogest on estrogen,VEGF,MT1-MMP and recurrence rate in patients with endometriosis after hysteroscopy with laparoscopy
摘要
Abstract
Objective:To analyze the influence of low-dose goserelin combined with dienogest on serum estrogen(E2),vascular endothelial growth factor(VEGF),membrane type 1 matrix metalloproteinase(MT1-MMP)and disease recurrence rate in patients with endometriosis(EMs)after hysteroscopy with laparoscopy,and to provide a basis for the optimization of clinical postoperative treatment regimen.Methods:A total of 120 patients with EMs were prospectively included.After hysteroscopy with laparoscopy,they were divided into combined group(n=60)and single drug group(n=60)based on different treatment regimens.The single drug group was treated with low-dose goserelin(1.8 mg/time,subcutaneous injection,once every 28 days),while the combined group was added with dienogest(2 mg/time,oral administration,once a day)on the basis of the single drug group,and both groups were treated for 6 months.The levels of serum hormones and cytokines,endometriosis health profile(EHP-5)scores,recurrence rate,ovarian reserve function and occurrence of adverse reactions were compared between the two groups.Results:After treatment,the levels of E2,P,VEGF and MT1-MMP were decreased in both groups(P<0.05).However,combined group exhibited a higher E2 level(P<0.05)and lower VEGF and MT1-MMP levels(P<0.05).There was no statistically significant difference in P level between the two groups after treatment(P>0.05).Both groups showed decreased anti-Müllerian hormone level and bilateral ovarian antral follicle count(P<0.05),but combined group had higher values than single drug group(P<0.05).Both groups exhibited reduced EHP-5 scores(P<0.05),with combined group had lower scores of pain and emotion items than single drug group(P<0.05).The recurrence rate at 12 months after surgery was lower in combined group than that in single drug group(P<0.05).The overall incidence rate of adverse reactions showed no statistically significant difference between the two groups(P>0.05).Conclusion:Low-dose goserelin combined with dienogest can down-regulate the levels of E2,VEGF and MT1-MMP in patients after EMs surgery,and reduce the recurrence rate,with controllable safety.关键词
子宫内膜异位症/腹腔镜手术/戈舍瑞林/地诺孕素/术后复发Key words
Endometriosis/Hysteroscopy with laparoscopy/Goserelin/Dienogest/Postoperative recurrence分类
医药卫生引用本文复制引用
王春梅,魏顺英,杨发珍,张莎,陈金融,杨爱萍..子宫内膜异位症腹腔镜手术后应用低剂量戈舍瑞林联合地诺孕素对患者雌激素水平、VEGF、MT1-MMP及复发率的影响[J].川北医学院学报,2026,41(6):673-677,5.基金项目
青海省卫生健康委员会指导性课题(2023-wjzkdx-369) （2023-wjzkdx-369）
青海大学医学部中青年科技项目(2023-kyy-7) （2023-kyy-7）
