摘要
目的探讨地诺孕素配合腹腔镜治疗子宫内膜异位症(EMT)的效果及对Rho/Rho激酶(ROCK)信号通路的影响。方法选取2020年6月至2022年6月湖南妇女儿童医院救治的80例EMT患者,按随机数字表法分为对照组(40例)和观察组(40例)。对照组采用单纯腹腔镜+醋酸亮丙瑞林微球治疗,观察组采用地诺孕素配合腹腔镜+醋酸亮丙瑞林微球治疗。治疗6个月后对比两组的临床疗效及不良反应发生情况;比较治疗前及治疗6个月后两组性交痛、月经期间疼痛、非经期下腹疼痛的视觉模拟评分法(VAS),卵泡刺激素(FSH)、促黄体生成素(LH)、雌二醇(E2)水平,以及Rho/ROCK信号通路相关分子(RhoA、ROCKⅠ、ROCKⅡ)水平。结果观察组治疗总有效率为95.00%,高于对照组的85.00%,差异有统计学意义(P<0.05)。治疗前,两组性交痛、月经期间疼痛、非经期下腹疼痛的VAS评分比较,差异均无统计学意义(P>0.05);治疗6个月后,两组性交痛、月经期间疼痛、非经期下腹疼痛的VAS评分均较治疗前降低(P<0.05),且观察组性交痛、月经期间疼痛、非经期下腹疼痛的VAS评分均低于对照组(P<0.05)。治疗前,两组FSH、LH、E2水平比较,差异均无统计学意义(P>0.05);治疗6个月后,两组FSH、LH、E2水平均较治疗前降低(P<0.05),且观察组FSH、LH、E2水平均低于对照组(P<0.05)。治疗前,两组RhoA、ROCKⅠ、ROCKⅡ水平比较,差异均无统计学意义(P>0.05);治疗6个月后,两组RhoA、ROCKⅠ、ROCKⅡ水平均较治疗前降低(P<0.05),且观察组RhoA、ROCKⅠ、ROCKⅡ水平均低于对照组(P<0.05)。治疗6个月后,观察组的不良反应总发生率为5.00%,明显低于对照组的15.00%,差异有统计学意义(P<0.05)。结论地诺孕素配合腹腔镜治疗EMT有助于提高临床疗效,改善患者疼痛评分,降低患者雌激素水平,还可抑制Rho/ROCK信号通路相关因子的表达,降低不良反应发生率。
Objective To investigate the effect of dienogest coordinated with laparoscopy in the treatment of endometriosis(EMT)and its impact on Rho/LOCK signal pathway.Methods Eighty patients with EMT treated in Hunan Women and Children′s Hospital from June 2020 to June 2022 were selected and divided into the control group(40 cases)and observation group(40 cases)according to the random number table method.The control group adopted simple laparoscopy and leuprorelin acetate microspheres,while the observation group was treated with dienogest coordinated with laparoscopy and leuprorelin acetate microspheres.The clinical efficacy and incidence of adverse reactions after 6 months of treatment were compared between the two groups;the visual analogue scale(VAS)scores of sexual intercourse pain,pain during menstruation period and lower abdominal pain during the non-menstruation period,levels of follicle stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2)and levels of Rho/ROCK signaling pathway related molecules(RhoA,ROCKⅠ,ROCKⅡ)before treatment and in 6 months after treatment were compared between the two groups.Results The total effective rate in the observation group was 95.00%,which was higher than 85.00%in the control group,and the difference was statistically significant(P<0.05).Before treatment,there was no statistically significant difference in the VAS scores of sexual intercourse pain,pain menstrual period,and lower abdominal pain during non-menstrual period between the two groups(P>0.05);after 6 months of treatment,the VAS scores of sexual intercourse pain,menstrual pain,and non-menstrual lower abdominal pain in both groups were decreased compared to before treatment(P<0.05),moreover the VAS scores of sexual intercourse pain,menstrual pain and non menstrual lower abdominal pain in the observation group were lower than those in the control group(P<0.05).Before treatment,there was no statistically significant difference in the levels of FSH,LH and E2 between the two groups(P>0.05);after 6 months of treatment,the levels of FSH,LH and E2 in both groups were decreased compared to before treatment(P<0.05),moreover the levels of FSH,LH and E2 in the observation group were lower than those in the control group(P<0.05).Before treatment,there was no statistically significant difference in the levels of RhoA,ROCKⅠ,and ROCKⅡbetween the two groups(P>0.05);after 6 months of treatment,the levels of RhoA,ROCKⅠand ROCKⅡin both groups were decreased compared with before treatment(P<0.05),moreover the levels of RhoA,ROCKⅠand ROCKⅡin the observation group were lower than those in the control group(P<0.05).After 6 months of treatment,the total incidence rate of adverse reactions in the observation group was 5.00%,which was significantly lower than 15.00%in the control group,and the difference was statistically significant(P<0.05).Conclusion Dienogest coordinated with laparoscopy in treating EMT is conducive to increase the clinical efficacy,improve the patients′pain scores,reduce the estrogen levels,inhibit the expression of Rho/ROCK signaling pathway related factors and reduce the incidence rate of adverse reactions.
作者
王冉
杨春燕
谭琳玉
张清华
何芷若
WANG Ran;YANG Chunyan;TAN Linyu;ZHANG Qinghua;HE Zhiruo(Department of Gynecology,Hunan Women′s and Children′s Hospital,Changsha,Hunan 410006,China;Department of Gynecology,Huaihua Municipal Second People′s Hospital,Huaihua,Hunan 418000,China)
出处
《检验医学与临床》
CAS
2024年第12期1745-1749,共5页
Laboratory Medicine and Clinic
