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目的探析腹腔镜与促性腺激素释放激素类似物(GnRH-α)联合治疗子宫内膜异位症(EMT)对血清血管内皮生长因子(VEGF)、白细胞介素-18(IL-18)、肿瘤坏死因子-α(TNF-α)的影响及临床意义。方法分析2014年2月-2015年10月在该院接受腹腔镜手术治疗的111例EMT患者的临床资料。随机将入选者分成观察组(腹腔镜术+GnRH-α,57例)和对照组(腹腔镜术,54例)。比较两组患者的一般资料及治疗前后的视觉模拟评分法(VAS)分数、卵泡刺激素(FSH)、雌二醇(E2)、血清IL-18、TNF-α、VEGF水平及妊娠率。结果两组患者基线资料比较,差异无统计学意义(P>0.05);两组患者治疗前,痛经、盆腔痛及性交痛VAS评分、FSH与E2水平、IL-18、TNF-α及VEGF比较,差异均无统计学意义(P>0.05);而治疗后,观察组患者痛经、盆腔痛及性交痛VAS评分、FSH与E2水平、IL-18、TNF-α及VEGF水平均显著低于对照组(P<0.01)。术后观察组患者妊娠率(56.1%)明显高于对照组(25.9%)(χ~2=10.43,P=0.001)。结论 EMT患者采用腹腔镜+GnRH-α类药物治疗的临床治疗效果更为突出,抑制血清IL-18、TNF-α及VEGF水平的作用更强,术后患者的妊娠机会也更大。
Objective To investigate the effect of laparoscopic combined with gonadotropin-releasing hormone analogues (GnRH-α) on endometriosis (EMT) and serum levels of vascular endothelial growth factor (VEGF), interleukin-18 Effect of TNF-α and its clinical significance. Methods Clinical data of 111 EMT patients who underwent laparoscopic surgery in our hospital from February 2014 to October 2015 were analyzed. The participants were randomly divided into observation group (laparoscopic + GnRH-α, 57 cases) and control group (laparoscopic surgery, 54 cases). The general data of two groups were compared before and after treatment with visual analogue scale (VAS) score, follicle stimulating hormone (FSH), estradiol (E2), serum IL-18, TNF-α, VEGF levels and pregnancy rate. Results There was no significant difference in baseline data between the two groups (P> 0.05). Before treatment, VAS scores, FSH and E2 levels, IL-18, TNF-α and VEGF in patients with dysmenorrhea, pelvic pain and pain were compared between the two groups (P> 0.05). After treatment, VAS scores, FSH and E2 levels, IL-18, TNF-α and VEGF levels in dysmenorrhea, pelvic pain and painful intercourse in the observation group were significantly lower than those in the control Group (P <0.01). The pregnancy rate in the postoperative observation group (56.1%) was significantly higher than that in the control group (25.9%) (χ ~ 2 = 10.43, P = 0.001). Conclusions The clinical effect of laparoscopic + GnRH-α therapy is more prominent in patients with EMT. The effect of inhibiting the serum levels of IL-18, TNF-α and VEGF is stronger and the chances of pregnancy after pregnancy are greater.