子宫腺肌病患者采用曼月乐联合小剂量米非司酮治疗的效果及对血清神经生长因子可溶性CD147血管内皮生长因子水平变化的影响
|
摘要
目的:探讨子宫腺肌病患者采用曼月乐联合小剂量米非司酮治疗的效果及对血清神经生长因子(NGF)、可溶性CD147(sCD147)、血管内皮生长因子(VEGF)水平变化的影响。方法:选择2015年4月至2017年4月于我院接受治疗的92例子宫腺肌病患者,按简单随机数字表法分为对照组和研究组,每组46例。对照组予以曼月乐治疗,研究组在对照组基础上加以小剂量米非司酮治疗。比较两组临床疗效,治疗前、治疗后2个月、4个月月经量,痛经程度评分,子宫内膜厚度,子宫体积,血清NGF,sCD147,VEGF,及不良反应发生情况。结果:研究组总有效率高于对照组,比较有统计学差异(P <0.05)。治疗后2个月、4个月,两组月经量,痛经程度评分,子宫内膜厚度,子宫体积均较治疗前下降,研究组均低于对照组(P<0.05)。两组血清NGF,sCD147,VEGF均低于治疗前,研究组低于对照组,比较有统计学差异(P<0.05)。两组不良反应发生情况比较无差异(P>0.05)。结论:曼月乐联合小剂量米非司酮治疗子宫腺肌病的疗效肯定,有效改善临床症状,能够降低血清NGF、Scd147、VEGF水平,可作为子宫腺肌病的优选治疗方案。
Objective: To discuss the clinical efficacy of menorrine combined with small dose mifepristone in treatment adenomyosis patients and its influences on nerve growth factor(NGF),soluble CD147(sCD147),vascular endothelial growth factor(VEGF). Methods: 92 patients with adenomyosis who received therapy from April 2015 to April 2017 in our hospital were treated,according to simple random number table method,those patients were divided into control group and the research group,with 46 cases in each group. The control group was treated with mirena,and the research group was treated with low-dose mifepristone based on the control group. Then clinical outcomes,menstrual volume,menstrual pain score,endometrial thickness,uterine volume,serum NGF,sCD147,VEGF before treatment,2 months,4 months after treatment,and adverse reactions occurred between two group was compared. Results: Total effective rate in research group was higher than that the control group,and the difference was statistically significant(P <0.05).After treatment 2 months,4 months,menstrual quantity,menstrual pain score,endometrial thickness,uterine volume,in both group was decreased,the research group was lower than the control group(P < 0.05). serum levels of NGF,sCD147,VEGF in both group were decreased,the research group was lower than the control group,and the difference was statistically significant(P <0.05). The adverse reactions between the two groups was no difference(P >0.05). Conclusion: Manyuela combined with low-dose mifepristone in the treatment of adenomyosis has a definite effect. It can effectively improve the clinical symptoms and reduce the levels of serum NGF,Scd147 and VEGF. It can be used as an optimal treatment for adenomyosis.
Objective: To discuss the clinical efficacy of menorrine combined with small dose mifepristone in treatment adenomyosis patients and its influences on nerve growth factor(NGF),soluble CD147(sCD147),vascular endothelial growth factor(VEGF). Methods: 92 patients with adenomyosis who received therapy from April 2015 to April 2017 in our hospital were treated,according to simple random number table method,those patients were divided into control group and the research group,with 46 cases in each group. The control group was treated with mirena,and the research group was treated with low-dose mifepristone based on the control group. Then clinical outcomes,menstrual volume,menstrual pain score,endometrial thickness,uterine volume,serum NGF,sCD147,VEGF before treatment,2 months,4 months after treatment,and adverse reactions occurred between two group was compared. Results: Total effective rate in research group was higher than that the control group,and the difference was statistically significant(P <0.05).After treatment 2 months,4 months,menstrual quantity,menstrual pain score,endometrial thickness,uterine volume,in both group was decreased,the research group was lower than the control group(P < 0.05). serum levels of NGF,sCD147,VEGF in both group were decreased,the research group was lower than the control group,and the difference was statistically significant(P <0.05). The adverse reactions between the two groups was no difference(P >0.05). Conclusion: Manyuela combined with low-dose mifepristone in the treatment of adenomyosis has a definite effect. It can effectively improve the clinical symptoms and reduce the levels of serum NGF,Scd147 and VEGF. It can be used as an optimal treatment for adenomyosis.
引文
[1] de Bruijn AM,Smink M,Lohle PNM,et al. Uterine artery embolization for the treatment of adenomyosis:a systematic review and meta-analysis[J]. Vasc Interv Radiol,2017,28(12):1629~1642.
[2]桂琦,刘洋,孙春意,等.曼月乐环治疗子宫腺肌病75例临床观察[J].昆明医科大学学报,2015,36(5):115~117.
[3]邓丽,刘其友.子宫腺肌病神经生长因子蛋白表达水平与盆腔疼痛的发生机制研究[J].川北医学院学报,2017,32(1):93~95.
[4] Prathoomthong S,Tingthanatikul Y,Lertvikool S,et al. The Effects of Dienogest on Macrophage and Natural Killer Cells in Adenomyosis:A Randomized Controlled Study[J]. Int Fertil Steril,2018,11(4):279~286.
[5] Choi EJ,Cho SB,Lee SR,et al. Comorbidity of gynecological and non-gynecological diseases with adenomyosis and endometriosis[J]. Obstet Gynecol Sci,2017,60(6):579~586.
[6]张凤格,米鑫.曼月乐治疗子宫腺肌病所致月经量增多及中重度痛经的临床疗效观察[J].生殖医学杂志,2015,24(6):494~496.
[7]徐晓颖,尤静洁.曼月乐治疗子宫腺肌症的临床疗效和安全性分析[J].中国妇幼保健,2017,32(13):2876~2878.
[8]郭芝亮,区霞晖,石莹.左炔诺孕酮缓释系统联合小剂量米非司酮治疗子宫腺肌病的临床研究[J].现代医学,2014,42(3):273~276.
[9]曹丽娟,舒新军.曼月乐联合米非司酮治疗子宫腺肌病的临床研究[J].海南医学院学报,2016,22(6):586~588.
[2]桂琦,刘洋,孙春意,等.曼月乐环治疗子宫腺肌病75例临床观察[J].昆明医科大学学报,2015,36(5):115~117.
[3]邓丽,刘其友.子宫腺肌病神经生长因子蛋白表达水平与盆腔疼痛的发生机制研究[J].川北医学院学报,2017,32(1):93~95.
[4] Prathoomthong S,Tingthanatikul Y,Lertvikool S,et al. The Effects of Dienogest on Macrophage and Natural Killer Cells in Adenomyosis:A Randomized Controlled Study[J]. Int Fertil Steril,2018,11(4):279~286.
[5] Choi EJ,Cho SB,Lee SR,et al. Comorbidity of gynecological and non-gynecological diseases with adenomyosis and endometriosis[J]. Obstet Gynecol Sci,2017,60(6):579~586.
[6]张凤格,米鑫.曼月乐治疗子宫腺肌病所致月经量增多及中重度痛经的临床疗效观察[J].生殖医学杂志,2015,24(6):494~496.
[7]徐晓颖,尤静洁.曼月乐治疗子宫腺肌症的临床疗效和安全性分析[J].中国妇幼保健,2017,32(13):2876~2878.
[8]郭芝亮,区霞晖,石莹.左炔诺孕酮缓释系统联合小剂量米非司酮治疗子宫腺肌病的临床研究[J].现代医学,2014,42(3):273~276.
[9]曹丽娟,舒新军.曼月乐联合米非司酮治疗子宫腺肌病的临床研究[J].海南医学院学报,2016,22(6):586~588.