GnRH–a 对子宫内膜异位症患者子宫 内膜 PDGF、LN 表达的影响
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白雨昕,女,主治医师,主要研究方向是妇科肿瘤、妇科生殖内分泌。

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R 711.74

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Effect of GnRH-a on the Expression of PDGF and LN in the Endometrium of Patients with Endometriosis
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    摘要:

    摘 要目的:探讨促性腺激素释放激素激动剂(GnRH–a)对子宫内膜异位症(EM)患者子宫内膜血小板衍生因子 (PDGF)、人层粘连蛋白(LN)表达的影响。 方法:选取 2019 年 5 月至 2022 年 3 月佳木斯市中心医院收治的 84 例 EM 患 者作为研究对象,将患者随机分为对照组和观察组,各 42 例。对照组给予腹腔镜下手术治疗,观察组在对照组治疗的基础 上给予 GnRH–a 治疗,检测并比较所有患者治疗前后子宫内膜 PDGF、LN 表达变化情况。 结果:观察组患者治疗 3 个月后 的总有效率为 97.6 %,与对照组的 85.7 % 相比有显著提高,差异具有统计学意义(P < 0.05)。治疗后,观察组患者血清 黄体生成素(LH)含量明显低于治疗前,与对照组比较也明显更低,差异均具有统计学意义(P < 0.05);两组患者治疗 前后的血清卵泡刺激素(FSH)含量比较,差异无统计学意义(P > 0.05)。治疗后,两组患者的子宫内膜 PDGF 表达水 平明显低于治疗前,LN 表达水平与治疗前相比明显增高,差异具有统计学意义(P < 0.05),治疗后观察组 PDGF、LN 表达水平与对照组比较,差异具有统计学意义(P < 0.05)。两组患者治疗后的痛经视觉模拟评分法(VAS)评分都显著低 于治疗前,且观察组显著低于对照组,差异具有统计学意义(P < 0.05)。两组患者治疗后的头晕失眠、情绪波动、乏力、 潮热盗汗等不良反应发生率比较,差异无统计学意义(P > 0.05)。 结论:GnRH–a 在 EM 患者治疗的应用能提高治疗效果, 降低患者的痛经程度,也可抑制血清 LH 的水平,有利于子宫内膜 PDGF、LN 水平恢复平衡。

    Abstract:

    AbstractObjective To investigate the effect of different concentration of ropivacaine epidural analgesia on parturients. Methods Eighty primiparas who underwent painless delivery in the First Affiliated Hospital of Henan University of Chinese Medicine from January 2019 to January 2022 were retrospectively selected as the research objects. Among them, 34 patients received low concentration of ropivacaine hydrochloride for epidural labor analgesia, which was the low concentration group. 46 cases were treated with ropivacaine hydrochloride ,which was the high concentration group. Clinical data such as labor time, uterine contraction, pain and delivery outcome were collected. The first stage of labor, the second stage of labor, the third stage of labor and the total labor time of the two groups were compared. The duration and interval of uterine contractions were compared between the two groups before analgesia (T1), 4 cm dilation of the uterine orificum (T2), complete dilation of the uterine orificum (T3), and visual analog scale (VAS) scores before analgesia, 10 min, 30 min and 1 h after analgesia. The amount of postpartum blood loss, the amount of oxytocin, urethral catheterization during delivery and the rate of cesarean section were compared between the two groups. Results There was no significant difference in the first stage of labor, second stage of labor, third stage of labor and total stage of labor between the two groups (P > 0.05) . The statistical results of uterine contractions showed that the duration of T2 and T3 in the low concentration group was longer than those in the high concentration group, the differences were statistically significant (P < 0.05), while the interval time was shorter than that in the high concentration group, the difference was statistically significant (P < 0.05). At 10 min, 30 min and 1 h after analgesia, VAS scores in the low concentration group were higher than those in the higher concentration group, and the differences were statistically significant (P < 0.05). The amount of oxytocin in the low concentration group was lower than that in the high concentration group, and the difference was statistically significant (P < 0.05). Conclusion Different concentrations of local anesthesia drugs used during epidural labor analgesia have different effects on parturients. Low concentration ropivacaine can greatly reduce the adverse effects on parturients under the premise of guaranteeing the analgesic effect.

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  • 收稿日期:2023-03-06
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  • 在线发布日期: 2023-08-08
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