CAJ | 학술논문

目的：比较子宫内膜异位症患者术后应用曲普瑞林与米非司酮的临床效果观察及对血清CA125及抗子宫内膜抗体的影响，为临床治疗提供参考。方法将60例子宫内膜异位症患者随机分为Ⅰ组30例和Ⅱ组30例，Ⅰ组患者术后月经来潮第1天给予米非司酮12．5 mg／d，1次／d，Ⅱ组患者术后月经来潮第1天给予曲普瑞林3．75 mg，每28天1次，连用3个月，治疗前后观察患者症状及体征变化情况，进行月经量及痛经评分，取肘上静脉血检测血清 CA125及抗子宫内膜抗体水平，评价两组患者临床疗效，观察两组不良反应发生情况，所有患者随访1年，统计1年内累积妊娠率。结果Ⅰ组和Ⅱ组治疗后 CA125、EMab、月经量评分、痛经评分分别为（18．2±2．8）U ／mL 和（8．8±3．2）U ／mL，（405．2±141．1）pg／mL 和（202．1±79．8）pg／mL，（18．85±6．32）分和（7．68±4．19）分，（1．91±0．35）分和（0．95±0．63）分，均较治疗前明显降低，（t ＝8.433、14．824，7．659、14．578，20．772、26．286，15．853、19．513，均 P ＜0．01），Ⅱ组治疗后 CA125、EMab、月经量评分、痛经评分水平明显低于Ⅰ组，t ＝5．711、6．632、6．675、5．624，均 P ＜0．01）；Ⅰ组与Ⅱ组的临床总有效率、妊娠率、复发率分别为96．67％和93．33％，53．33％和50％，3．33％和6．67％，差异无统计学意义（均 P ＞0.05）；Ⅰ组阴道不规则出血发生率为23．33％，明显高于于Ⅱ组的3．33％（χ2＝5．192，P ＜0．05）。结论子宫内膜异位症术后使用曲普瑞林与米非司酮的临床效果相当，但曲普瑞林对血清 CA125及抗子宫内膜抗体水平的下调作用更强，减轻术后阴道异常出血和痛经症状，术后妊娠率及复发率良好，可作为子宫内膜异位症术后治疗的推荐药物。
목적：비교자궁내막이위증환자술후응용곡보서림여미비사동적림상효과관찰급대혈청CA125급항자궁내막항체적영향，위림상치료제공삼고。방법장60례자궁내막이위증환자수궤분위Ⅰ조30례화Ⅱ조30례，Ⅰ조환자술후월경래조제1천급여미비사동12．5 mg／d，1차／d，Ⅱ조환자술후월경래조제1천급여곡보서림3．75 mg，매28천1차，련용3개월，치료전후관찰환자증상급체정변화정황，진행월경량급통경평분，취주상정맥혈검측혈청 CA125급항자궁내막항체수평，평개량조환자림상료효，관찰량조불량반응발생정황，소유환자수방1년，통계1년내루적임신솔。결과Ⅰ조화Ⅱ조치료후 CA125、EMab、월경량평분、통경평분분별위（18．2±2．8）U ／mL 화（8．8±3．2）U ／mL，（405．2±141．1）pg／mL 화（202．1±79．8）pg／mL，（18．85±6．32）분화（7．68±4．19）분，（1．91±0．35）분화（0．95±0．63）분，균교치료전명현강저，（t ＝8.433、14．824，7．659、14．578，20．772、26．286，15．853、19．513，균 P ＜0．01），Ⅱ조치료후 CA125、EMab、월경량평분、통경평분수평명현저우Ⅰ조，t ＝5．711、6．632、6．675、5．624，균 P ＜0．01）；Ⅰ조여Ⅱ조적림상총유효솔、임신솔、복발솔분별위96．67％화93．33％，53．33％화50％，3．33％화6．67％，차이무통계학의의（균 P ＞0.05）；Ⅰ조음도불규칙출혈발생솔위23．33％，명현고우우Ⅱ조적3．33％（χ2＝5．192，P ＜0．05）。결론자궁내막이위증술후사용곡보서림여미비사동적림상효과상당，단곡보서림대혈청 CA125급항자궁내막항체수평적하조작용경강，감경술후음도이상출혈화통경증상，술후임신솔급복발솔량호，가작위자궁내막이위증술후치료적추천약물。
Objective To compare the clinical effects and influence on CA125,endometrial antibody of trip-torelin the treatment of endometriosis surgery endometriosis surgery,to provide reference for clinical treatment. Methods 60 patients with endometriosis surgery were randomly divided into 30 cases of I group and 30 cases of II group,I group was treated with mifepristone on the first days after menstruation 12.5mg/d,qd,II group was given triptorelin 3.75mg,every 28 days for 1 times,treated for 3 months,the symptoms and signs before and after treatment were observed,then menstruation and dysmenorrhea score were evaluated,Elbow vein blood was taken out for calculat-ing CA125 and serum antiendometrial antibody,the clinical efficacy were evaluated and the adverse reactions were observed,all patients were followed up for 1 years,then 1 years cumulative pregnancy rate were recorded.Results The CA125,EMab,menstrual score,dysmenorrhea score of I group and II group after the treatment were (18.2 ±2.8)U /mL and (8.8 ±3.2)U /mL,(405.2 ±141.1)pg/mL and (202.1 ±79.8)pg/mL,(18.85 ±6.32)score and (7.68 ± 4.19)score,(1.91 ±0.35)score and (0.95 ±0.63)score,all index of both group after treatment were significantly lower than those before treatment(t =8.433 and 14.824,7.659 and 14.578,20.772 and 26.286,15.853 and 19.513,P <0.01),all index of II group after treatment were significantly lower than those of I group(t =5.711, 6.632,6.675,5.624,all P <0.01).The total effective rate,pregnancy rate,recurrence rate of I group and II group were 96.67% and 93.33%,53.33% and 50%,3.33% and 6.67%,the difference were not statistically significant (P >0.05);the irregular vaginal bleeding rate of I group was 23.33%,the II group were 3.33%,χ2 =5.192,P <0.05.Conclusion Triptorelin and mifepristone has same clinical effect in endometriosis postoperative,but triptorelin can reduce more effectively the CA125 and anti endometrium antibody,abnormal vaginal bleeding and reduce dysmen-orrhea postoperative,postoperative recurrence rate and pregnancy rate is good,can be used as a recommended drugs in the treatment patients with endometriosis surgery.