戊酸雌二醇联合醋酸甲羟孕酮预防人流术后宫腔粘连效果研究.docVIP

戊酸雌二醇联合醋酸甲羟孕酮预防人流术后宫腔粘连效果研究 　　[摘要] 目的 探讨戊酸雌二醇联合醋酸甲羟孕酮预防人流术后宫腔粘连的效果。 方法 选择2012年1月～2015年12月来我院进行负压吸宫术的患者200例，按照患者意愿分为对照组和试验组。对照组患者术后不接受口服雌激素和孕激素治疗；试验组患者术后立即口服戊酸雌二醇，并于后半周期加服醋酸甲羟孕酮。评价两组患者治疗后3个月的治疗效果，测定治疗后两组患者血清六项性激素水平。检测两组患者治疗前后子宫内膜组织中转化生长因子-β1（TGF-β1）和基质金属蛋白酶（MMP-9）表达量。 结果 试验组的治疗有效率显著高于对照组（P0.05）。治疗后两组患者宫颈组织中TGF-β1表达量显著下降且MMP-9表达量显著升高（P0.05），但试验组患者两项指标变化更加明显（P0.05）。 结论 戊酸雌二醇和醋酸甲羟孕酮预防人流术后宫腔粘连效果明显，对机体激素水平影响小，值得临床推广。 　　[关键词] 戊酸雌二醇；醋酸甲羟孕酮；转化生长因子；基质金属蛋白酶 　　[中图分类号] R713.4 [文献标识码] B [文章编号] 1673-9701（2016）36-0074-03 　　[Abstract] Objective To investigate the effect of estradiol valerate combined with medroxyprogesterone acetate in preventing intrauterine adhesions after abortion. Methods A total of 200 patients who underwent Negative pressure uterine aspiration surgery in our hospital from January 2012 to December 2015 were enrolled and divided into control group and experimental group according to the patients intention. Patients in the control group did not receive oral estrogen and progesterone after surgery. The patients in the experimental group were treated with estradiol valerate immediately after the operation and served with medroxyprogesterone acetate in the latter half of the period. The therapeutic effect of the two groups was evaluated at three months after the treatment. Six serum hormone levels in patients of the two groups after treatment were measured. The expressions of transforming growth factor in tissue（TGF-β1） and matrix metalloproteinase（MMP-9） in the endometrium of the two groups before and after treatment were detected. Results The effective rate of the treatment group was significantly higher than that of the control group（P0.05）. The expression of TGF-β1 in cervical tissue was significantly decreased and the expression of MMP-9 was significantly increased in the two groups after treatment（P0.05）. But the experimental group had two indicators which changed more significantly（P0.05）. Conclusion Estradiol valerate and medroxyprogesterone acetate are