醋酸亮丙瑞林联合反加替勃龙治疗子宫内膜异位症的临床研究

发布时间：2018-07-10 01:04

本文选题：醋酸亮丙瑞林 + 反加疗法　；参考：《新疆医科大学》2017年硕士论文

【摘要】：目的:比较醋酸亮丙瑞林(LA)联合反加不同剂量替勃龙对子宫内膜异位症(EM)患者内分泌水平、血清骨钙素(BGP)及骨密度(BMD)的影响。方法:选择2014年3月至2015年3月于新疆医科大学第一附属医院妇科三病区行腹腔镜保守性手术,病理结果证实为EM,术后使用LA治疗的患者148例,随机分为3组,A组48例,未反向添加任何药物,仅口服钙片。B组50例给予反加药物替勃龙1.25mg/d,C组50例给与反加药物替勃龙2.5mg/d,B、C组自第一次注射LA后给与反加药物替勃龙,连续服用至疗程结束。记录治疗前后两组血雌二醇(E2)、卵泡刺激素(FSH)、促黄体生成素(LH)、BG P及BMD变化。并随访A、B、C3组停药后6个月、12个月的BGP及MD变化情况。结果:3组患者治疗前后测试女性激素结果显示FS H、LH、E2明显下降,前后比较具有统计学差异(P0.05);治疗后各组间激素比较无统计学差异(P0.05);3组患者BGP值均比较结果显示治疗后均升高,其中A组患者治疗前后比较具有统计学差异(P0.05);B、C两组患者治疗前后无统计学差异(P0.05);3组患者随访结果显示A组患者24W治疗后腰椎BMD低于治疗前,前后比较具有统计学差异(P0.05),停药后6个月及12个月后腰椎BMD值缓慢上升,两次随访结果显示与治疗前相比差异具有统计性(P0.05);B、C两组患者随访结果显示腰椎骨密BMD低于治疗前,二者比较无统计学差异(P0.05)。A、B、C3组股骨粗隆BMD在用药24w后、停药后6个月及12个月均未恢复至治疗前,但较治疗前比较差异无统计学意义(P0.05)。结论:LA联合替勃龙治疗EM可减少骨质丢失,且低剂量替勃龙可维持BMD。
[Abstract]:Objective: To compare the effects of light propane acetate (LA) combined with different doses of troneon on endocrine level, Serum Osteocalcin (BGP) and bone mineral density (BMD) in patients with endometriosis (EM). Methods: laparoscopic conservative surgery was performed in the First Affiliated Hospital of Xinjiang Medical University from March 2014 to March 2015 in the three Department of gynecologic department in the First Affiliated Hospital of Xinjiang Medical University. 148 patients with EM and LA after operation were randomly divided into 3 groups, 48 cases in group A, no reverse addition of any medicine, only 50 cases of the calcium tablet.B group were given the anti adding drug tren 1.25mg/d, and the group C was given the anti addition drug tren 2.5mg/d, B, and the C group from the first injection of LA after the first injection to the end of the course to the end of the course. Two groups of blood estradiol (E2), follicle stimulating hormone (FSH), luteinizing hormone (LH), BG P and BMD were observed before and after treatment. The changes of BGP and MD were followed up by A, B, and C3 group after 6 months, 12 months after treatment. There was no statistical difference between groups (P0.05). The results of BGP values in the 3 groups showed that all of the patients in the group A had a statistically significant difference (P0.05) before and after treatment (P0.05), and there was no statistical difference between before and after treatment in group A and C (P0.05). The follow-up results in the 3 group showed that the lumbar BMD was lower than before and before the treatment, before and after the 24W treatment in the group A. Compared with the statistical difference (P0.05), 6 months and 12 months after the withdrawal of the lumbar BMD value slowly increased, two follow-up results showed that the difference was statistically significant compared with before treatment (P0.05); B, C two patients follow-up results showed that the bone density of the lumbar spine was lower than before the treatment, the two had no statistical difference (P0.05).A, B, C3 group femur BMD in 24W drug 24W. After 6 months and 12 months after drug withdrawal, no significant difference was found before treatment, but there was no significant difference compared with before treatment (P0.05). Conclusion: LA combined with the treatment of EM can reduce bone loss, and low dose of trerone can maintain BMD.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R711.71

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