检索历史 清除

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。

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.