GnRH-α 辅助腹腔镜对中重度子宫内膜异位症 患者5- 脂氧化酶、脂氧素A4 的影响

Effect of GnRH-α-assisted laparoscopy on 5-LOX and LXA4 in patients with moderate and severe endometriosis

摘要:

目的 探讨促性腺激素释放激素（GnRH-α）辅助腹腔镜治疗中、重度子宫内膜异位症患者的临 床疗效及其对5- 脂氧化酶（5-LOX）、脂氧素A4（LXA4）表达的影响。方法 选取2014~2016 年在郑州大学 第二附属医院就诊的78 例子宫内膜异位症患者随机纳入观察组（腹腔镜联合GnRH-α）及对照组（单用 腹腔镜），每组39 例；观察治疗前后两组患者手术基本情况、各项VAS 评分、临床疗效、性激素水平及5- LOX、LXA4 水平。结果 观察组在手术用时、术中出血量、术后肛门首次排气时间及住院时间均少于对照组， 且在缓解慢性盆腔痛、痛经及性交痛的效果优于对照组，差异有统计学意义（P <0.05）；此外，在治疗有效率 比较中观察组（84.6%）高于对照组（61.5%），同时，治疗后观察组的性激素水平（FSH、LH、E2）改善效 果优于对照组，观察组5-LOX（173.9±17.3）pg/ml、LXA4（439.5±48.3）pg/ml 表达水平均高于对照组的 （152.4±15.5）pg/ml、（367.1±42.4）pg/ml，差异均有统计学意义（P <0.05）。结论 促性腺激素释放激素有 助于提高机体5-LOX、LXA4 表达水平，调节性激素水平，从而提高腹腔镜在子宫内膜异位中的治疗效果。

Abstract:

Objective To investigate the clinical efficacy of gonadotropin-releasing hormone (GnRH-α) assisted laparoscopy in the treatment of moderate and severe endometriosis and its expression on 5-lipoxygenase (5-LOX) and lipoxin A4 (LXA4). Methods Totally 78 patients with endometriosis who were treated at the Second Affiliated Hospital of Zhengzhou University from 2014 to 2017 were randomly included in the observation group (laparoscopic GnRH-α) and the control group (laparoscopic alone). The differences of VAS scores, clinical efficacy, sex hormone levels and 5-LOX and LXA4 levels were compared between the two groups before and after treatment. Results In the observation group, the intraoperative blood loss, the first exhaust time and the time of hospitalization were lower than those of the control group, and the effect of relieving chronic pelvic pain, dysmenorrhea and sexual intercourse was better than that of the control group. (P < 0.05). In addition, treatment efficiency of the observation group (84.6%) was higher than the control group (61.5%), and the sex hormone level (FSH, LH, E2) was improved after the treatment group. The expression of LXA4 (439.5 ± 48.3 pg/ml) in the observation group was significantly higher than that in the control group (152.4 ± 15.5 pg/ml, 367.1 ± 42.4 pg/ml) (P < 0.05). Conclusion GnRH-α helps to improve the level of expression of 5-LOX and LXA4 and regulates the level of sex hormones, thereby improving the therapeutic effect of laparoscopy in endometriosis.