Effect of dinorgestrel on the curative effect after laparoscopic surgery for endometriosis

HUANG Qi; CUI Bin-bin; ZHOU Li-hua; YE Ming-zhu

doi:10.11659/jjssx.04E023008

您当前的位置：

首页 >

文章列表页 >

Effect of dinorgestrel on the curative effect after laparoscopic surgery for endometriosis

Clinical Research | 更新时间：2023-07-17

- Effect of dinorgestrel on the curative effect after laparoscopic surgery for endometriosis
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 32, Issue 7, Pages: 633-636(2023)
- 作者机构：
  
  厦门大学附属中山医院妇产科，福建厦门 361003
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.04E023008
  CLC： R713.4
- Published：25 July 2023，
  
  Received：04 April 2023，
扫描看全文
黄琦,崔彬彬,周丽华等.地诺孕素对子宫内膜异位症腹腔镜手术后疗效的影响[J].局解手术学杂志,2023,32(07):633-636.

HUANG Qi,CUI Bin-bin,ZHOU Li-hua,et al.Effect of dinorgestrel on the curative effect after laparoscopic surgery for endometriosis[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2023,32(07):633-636.
黄琦,崔彬彬,周丽华等.地诺孕素对子宫内膜异位症腹腔镜手术后疗效的影响[J].局解手术学杂志,2023,32(07):633-636. DOI： 10.11659/jjssx.04E023008.

HUANG Qi,CUI Bin-bin,ZHOU Li-hua,et al.Effect of dinorgestrel on the curative effect after laparoscopic surgery for endometriosis[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2023,32(07):633-636. DOI： 10.11659/jjssx.04E023008.

摘要

目的

观察地诺孕素对子宫内膜异位症（EMT）腹腔镜手术后患者卵巢储备功能及妊娠的影响。

方法

选择我院收治的120例EMT患者为研究对象，将其随机分为观察组（

=60）和对照组（

=60）。对照组术后于皮下注射醋酸亮丙瑞林微球治疗，观察组在对照组的基础上联合地诺孕素治疗。比较2组患者临床疗效、疼痛情况、卵巢储备功能指标、血清因子表达情况、妊娠与复发情况。

结果

观察组患者治疗后总有效率明显高于对照组（

0.05）。治疗后2组患者疼痛情况较治疗前明显改善（

0.05），且观察组疼痛改善情况优于对照组（

0.05）。2组患者治疗后窦卵泡（AFC）数量无明显变化（

0.05），抗缪勒管激素（AMH）水平较治疗前明显降低（

0.05），且观察组低于对照组（

0.05）。2组患者治疗后血管内皮生长因子（VEGF）、糖类抗原125（CA125）、半乳糖凝集素3（Gal-3）以及基质金属蛋白酶-2（MMP-2）等血清因子表达较治疗前明显降低（

0.05），且观察组低于对照组（

0.05）。术后随访1年，观察组患者妊娠率明显高于对照组（

0.05）；2组患者复发率比较差异无统计学意义（

0.05）。

结论

地诺孕素应用于EMT腹腔镜术后可有效提高患者临床疗效，改善卵巢储备功能及疼痛症状，提高妊娠率。

Abstract

Objective

To observe the effect of dinorgestrel on ovarian reserve function and pregnancy in patients with endometriosis （EMT） after laparoscopic surgery.

Methods

A total of 120 patients with EMT admitted to our hospital were selected as the research subjects， and they were randomly divided into the observation group （

=60） and the control group （

=60）. The control group was treated with subcutaneous injection of leuprorelin acetate microspheres after operation， while the observation group was treated with dinorgestrel on the basis of the control group. The clinical efficacy， pain， ovarian reserve function index， serum factor expression， pregnancy and recurrence were compared between the two groups.

Results

The total effective rate after treatment of the observation group was significantly higher than that of the control group （

0.05）. The pain after treatment of the two groups was significantly improved compared to that before treatment （

0.05）， and the pain improvement of the observation group was better than that of the control group （

0.05）. The number of antral follicle count （AFC） after treatment in the two groups had no obviously change （

0.05）， the anti-müllerian hormone （AMH） levels were significantly lower than those before treatment， and the observation group was lower than the control group （

0.05）. The expressions of serum factors such as vascular endothelial growth factor （VEGF）， carbohydrate antigen 125 （CA125）， recombinant human galectin-3 （Gal-3）， and matrix metalloproteinase-2 （MMP-2） after treatment in the two groups were significantly lower than those before treatment （

0.05）， and the observation group was lower than the control group （

0.05）.The patients were followed-up for 1 year， the pregnancy rate of the observation group was significantly higher than that of the control group （

0.05）； there was no statistically significant difference in the recurrence rate between the two groups （

0.05）.

Conclusion

The application of dinorgestrel after laparoscopic surgery for EMT can effectively improve the clinical efficacy， improve the ovarian reserve function and pain symptoms， and increase pregnancy rate of patients.

关键词

地诺孕素子宫内膜异位症卵巢储备功能妊娠

Keywords

dinorgestrelendometriosisovarian reserve functionpregnancy

references

Du Y，Zhang Z，Xiong W，et al.Estradiol promotes EMT in endometriosis via MALAT1/miR200s sponge function［J］.Reproduction，2019，157（2）：179.doi：10.1530/REP-18-0424http://dx.doi.org/10.1530/REP-18-0424.

Xiong W，Zhang L，Liu H，et al.E2‐mediated EMT by activation of β‐catenin/Snail signalling during the development of ovarian endometriosis［J］.J Cell Mol Med，2019，23（12）：8035-8045.doi：10.1111/jcmm. 14668http://dx.doi.org/10.1111/jcmm.14668.

Zubrzycka A，Migdalska-Sęk M，Jędrzejczyk S，et al.Circulating miRNAs related to epithelial-mesenchymal transitions （EMT） as the new molecular markers in endometriosis［J］.Curr Issues Mol Biol，2021，43（2）：900-916.doi：10.3390/cimb43020064http://dx.doi.org/10.3390/cimb43020064.

范晓玲，陈芳红.子宫内膜异位症腹腔镜术后辅助应用孕三烯酮与米非司酮的疗效比较［J］.临床医学研究与实践，2019，4（34）：111-112.doi：10.19347/j.cnki.2096-1413.201934047http://dx.doi.org/10.19347/j.cnki.2096-1413.201934047.

朱晓华，张晓兰，赵霞，等.不同药物治疗子宫内膜异位症合并不孕的疗效对比［J］.中国妇幼健康研究，2019，30（1）：85-89.doi：10.3969/j.issn.1673-5293.2019.01.021http://dx.doi.org/10.3969/j.issn.1673-5293.2019.01.021.

章琼，滕慧，胡玉利，等.注射用醋酸亮丙瑞林微球联合腹腔镜对子宫内膜异位症患者血清TIMP-1 MMP-9水平及受孕率的影响［J］.河北医学，2019，25（5）：726-732.doi：10.3969/j.issn.1006-6233.2019.05.05http://dx.doi.org/10.3969/j.issn.1006-6233.2019.05.05.

Wei Z，Hu Y，He X，et al.Knockdown hsa_circ_0063526 inhibits endometriosis progression via regulating the miR-141-5p/EMT axis and downregulating estrogen receptors［J］.Aging （Albany NY），2021，13（24）：26095.doi：10.18632/aging.203799http://dx.doi.org/10.18632/aging.203799.

Liu Y，Zhao R，Chi S，et al.UBE2C is upregulated by estrogen and promotes epithelial-mesenchymal transition via p53 in endometrial cancer UBE2C promotes EMT via p53 in endometrial cancer［J］.Mol Cancer Res，2020，18（2）：204-215.doi：10.1158/1541-7786http://dx.doi.org/10.1158/1541-7786.

徐冰，李华军，贾婉璐，等.地诺孕素用于难治性子宫内膜异位症疼痛的临床研究［J］.中华妇产科杂志，2021，56（3）：178-184.doi：10.3760/cma.j.cn112141-20200525-00444http://dx.doi.org/10.3760/cma.j.cn112141-20200525-00444.

中国中西医结合学会妇产科专业委员会.子宫内膜异位症中西医结合诊治指南［J］.中国中西医结合杂志，2019，39（10）：1169-1176.

Caruso S，Iraci M，Cianci S，et al.Effects of long-term treatment with Dienogest on the quality of life and sexual function of women affected by endometriosis-associated pelvic pain ［J］.J Pain Res，2019，29（12）：2371-2378.doi：10.2147/JPR.S207599http://dx.doi.org/10.2147/JPR.S207599.

Zmarzły N，Hermyt E，Kruszniewska-Rajs C，et al.Expression profile of EMT-related genes and miRNAs involved in signal transduction via the Wnt pathway and cadherins in endometrial cancer［J］.Curr Pharm Biotechnol，2021，22（12）：1663-1671.doi：10.2174/138920102166 6201218125900http://dx.doi.org/10.2174/1389201021666201218125900.

Zhang X，Nie D，Zhang L，et al.Study on diagnostic values and pathological conditions of serum HGF and CA199 in endometriosis［J］.Am J Transl Res，2021，13（4）：2849.

叶凌玫，金万里，陈纲.不孕症合并子宫内膜异位症47例腹腔镜治疗术后疗效的影响因素分析［J］.安徽医药，2020，24（7）：1431-1433.doi：10.3969/j.issn.1009-6469.2020.07.041http://dx.doi.org/10.3969/j.issn.1009-6469.2020.07.041.

王爽.曲普瑞林联合克龄蒙对腹腔镜子宫内膜异位症患者术后安全性及预后的影响［J］.临床药物治疗杂志，2019，17（8）：57-60.doi：10.3969/j.issn.1672-3384.2019.08.014http://dx.doi.org/10.3969/j.issn.1672-3384.2019.08.014.

曹啸俊，刘姝灵，陆舜华，等.地诺孕素对卵巢子宫内膜异位囊肿患者术后复发及卵巢储备功能的影响［J］.实用药物与临床，2021，24（9）：809-812.doi：10.14053/j.cnki.ppcr.202109007http://dx.doi.org/10.14053/j.cnki.ppcr.202109007.

李倩，谈海东，潘晓微.卵巢子宫内膜异位症术后地诺孕素结合体质辩证调理辅助疗效及对患者卵巢功能影响［J］.中国计划生育学杂志，2022，30（7）：1520-1524.doi： 10.3969/j.issn.1004-8189.2022.07.012http://dx.doi.org/10.3969/j.issn.1004-8189.2022.07.012.

Marcellin L，Santulli P，Bourdon M，et al.Serum antimüllerian hormone concentration increases with ovarian endometrioma size［J］.Fertil Steril，2019，111（5）：944-952.doi：10.1016/j.fertnstert. 2019.01.013http://dx.doi.org/10.1016/j.fertnstert.2019.01.013.

Yılmaz Hanege B，Güler Çekıç S，Ata B.Endometrioma and ovarian reserve： effects of endometriomata per se and its surgical treatment on the ovarian reserve［J］.Facts Views Vis Obgyn，2019，11（2）：151-157.

Muzii L，Galati G，Di Tucci C，et al.Medical treatment of ovarian endometriomas：a prospective evaluation of the effect of dienogest on ovarian reserve，cyst diameter，and associated pain［J］.Gynecol Endocrinol，2020，36（1）：81-83.doi：10.1080/09513590http://dx.doi.org/10.1080/09513590.

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Mechanism of estrogen regulating the invasion and migration of endometriosis stromal cells

Clinical study of laparoscopic surgery combined with anti-infection and dienogest in the treatment of endometriosis

Effects of puncture aspiration and hydrodissection stripping on ovarian reserve and fertility function in patients with ovarian endometriosis cyst

Related Author

LIAO Yuan

WANG Kai-ju

LI Hao-hui

CHEN Hui-ping

LI Xuan-yi

ZHANG Sen

CHANG Ru

GUO Chao

Related Institution

Department of Reproductive Medicine， Second Affiliated Hospital of Hainan Medical College

Operating Room， Hengshui People's Hospital

Department of Obstetrics and Gynecology,901th Hospital of Joint Logistics Support Force of PLA

⁰