GnRH-α对育龄期子宫内膜异位症患者术后卵巢功能的影响

摘要

Objective To investigate the effect of gonadotropin releasing hormone agonist(GnRH-α)on the ovarian function of patients with endometriosis in the childbearing age. Methods 50 cases of patients with endometriosis in our hospital from January 2015 to December 2015 were selected as the research object,and were randomly divided into two groups,each group of 25 cases. Two groups of patients were treated with laparoscopic conservative surgery. The observation group was treated with GnRH- alpha after operation,and the control group was not given any medicine after the operation,the serum sex hormone levels and antral follicle count(AFC) were measured in the two groups preoperatively,2 months and 6 months after treatment. All the patients were followed up for 1 years. The recurrence and spontaneous pregnancy in the two groups after 1 years were counted. Results The E2,FSH,LH and AFC in observation group after 2 months were significantly lower than that before operation (P<0.05),and returned to the preoperative level at 6 months after surgery(P>0.05);no significant change in group E2 before and after surgery, FSH,LH level control(P>0.05),but the level of AFC decreased after operation,until 6 months after surgery was significantly lower than that before operation(P<0.05). The recurrence rate of the observation group was 4%,which was significantly lower than that of the control group(P<0.05) within 1 years,and the natural pregnancy rate was significantly higher than that of the control group(P<0.05). Conclusion GnRH-α combined with postoperative treatment can effectively protect the ovarian reserve function of patients,reduce the postoperative recurrence rate and improve the natural pregnancy rate.%目的 探讨促性腺激素释放激素激动剂(GnRH-α)对育龄期子宫内膜异位症患者术后卵巢功能的影响.方法 选取2015年1月至12月收治的50例育龄期子宫内膜异位症患者作为观察对象,采取随机数字表将其分成两组,每组各25例.两组患者均采取腹腔镜保守手术治疗,观察组于术后联合给予GnRH-α治疗,对照组术后不给予任何药物治疗,分别于术前、治疗后2个月及6个月检测两组患者的血清性激素水平并测定窦卵泡计数(AFC),同时对所有患者进行为期1年的随访,统计两组术后1年内复发情况及自然妊娠情况.结果 观察组术后2个月雌二醇(E2)、卵泡刺激素(FSH)、黄体生成素(LH)及AFC水平均明显低于术前(P<0.05),术后6个月恢复至术前水平(P>0.05);对照组手术前后E2、FSH、LH水平无明显变化(P>0.05),但AFC水平术后持续下降,至术后6个月显著低于术前(P<0.05).观察组术后1年内复发率为4.00%,显著低于对照组(P<0.05),自然妊娠率为64.00%,显著高于对照组(P<0.05).结论 子宫内膜异位症术后联合GnRH-α治疗可有效保护患者的卵巢储备功能,降低术后复发率,同时提高术后自然妊娠率.