标题：曼月乐对子宫内膜息肉电切除术后患者的性激素、炎症因子及复发状况的影响

      作者：刘娟 1，闵丹 1，同慧莉 2    渭南市妇幼保健院妇科 1，产科 2，陕西 渭南 714000

      卷次： 2022年33卷21期

      【摘要】 目的 探讨曼月乐对宫腔镜子宫内膜息肉电切除术(TCRP)后患者的性激素、炎症因子及复发状况的影响。方法 选择2018年2月至2020年2月在渭南市妇幼保健院治疗的112例子宫内膜息肉患者为研究对象，根据随机数表法分为观察组和对照组各56例，对照组患者采用TCRP联合炔诺酮片口服治疗，观察组患者给予曼月乐联合TCRP治疗，均连续治疗 3个月。比较两组患者治疗前后的月经情况、子宫内膜厚度、血清白细胞介素-6(IL-6)、白细胞介素-10 (IL-10)、卵泡雌激素(FSH)、促黄体生成素(LH)和雌二醇(E2)水平，以及不良反应和术后随访3个月的复发情况。结果 治疗后，观察组患者的月经期、月经量、子宫内膜厚度分别为(5.41±0.13) d、(45.16±7.83) mL、(4.01±1.04) mm，明显短(厚)于对照组的(7.26±0.17) d、(58.49±3.49) mL、(3.34±0.87) mm，差异均有统计学意义(P<0.05)；治疗后，观察组患者的血清 IL-6水平为(18.14±2.95) ng/mL、明显低于对照组的(23.06±3.02) ng/mL，IL-10水平为(19.73±2.50) ng/mL，明显高于对照组的(14.15±3.78) ng/mL，差异均有统计学意义(P<0.05)；两组患者治疗前后的血清FSH、LH、E2水平比较差异均无统计学意义(P>0.05)；观察组患者的不良反应总发生率为3.57%，明显低于对照组的17.86%，差异有统计学意义(P<0.05)；术后3个月复查显示，观察组患者子宫内膜息肉复发8例(14.29%)，略少于对照组的 13例(23.21%)，但差异无统计学意义(P>0.05)。结论 曼月乐联合TCRP治疗子宫内膜息肉能减少患者的炎症反应，临床疗效显著，且安全性较好，具有临床应用价值。
      【关键词】 子宫内膜息肉；宫腔镜下子宫内膜息肉电切除术；曼月乐；白细胞介素-6；白细胞介素-10；性激素；疗效
      【中图分类号】 R711.74 【文献标识码】 A 【文章编号】 1003—6350（2022）21—2780—04

Effect of Mirena on sex hormones, inflammatory factors, and recurrence in patients after transcervical resectionof polyp.
LIU Juan 1, MIN Dan 1, TONG Hui-li 2. Department of Gynecology 1, Department of Obstetrics 2, Weinan Maternaland Child Health Hospital, Weinan 714000, Shaanxi, CHINA
【Abstract】 Objective To investigate the effects of Mirena on sex hormones, inflammatory factors, and recur-rence in patients after transcervical resection of polyp (TCRP). Methods A total of 112 patients with endometrial pol-yps admitted to Weinan Maternal and Child Health Hospital from February 2018 to February 2020 were selected as sub-jects. According to the random number table method, they were divided into an observation group and a control group,with 56 patients in each group. Patients in the control group were treated with TCRP combined with norethindrone tab-lets orally, and the patients in the observation group were treated with Mirena combined with TCRP, for 3 months. Themenstruation, endometrial thickness, serum interleukin-6 (IL-6), interleukin-10 (IL-10), follicular estrogen (FSH), lu-teinizing hormone (LH), and estradiol (E2) levels before and after treatment, as well as adverse reactions and recurrenceduring 3 months of follow-up were compared between the two groups. Results After treatment, the menstrual period,menstrual volume, and endometrial thickness in the observation group were (5.41±0.13) d, (45.16±7.83) mL, (4.01±1.04) mm, which were significantly shorter or thicker than (7.26±0.17) d, (58.49±3.49) mL, (3.34±0.87) mm in the con-trol group (P<0.05). After treatment, the serum IL-6 level in the observation group was (18.14±2.95) ng/mL, which wassignificantly lower than (23.06±3.02) ng/mL in the control group, and the IL-10 level in the observation group was(19.73±2.50) ng/mL, significantly higher than (14.15±3.78) ng/mL in the control group (P<0.05). There was no signifi-cant difference in serum FSH, LH and E2 levels between the two groups before and after treatment (P>0.05). The totalincidence of adverse reactions in the observation group was 3.75%, which was significantly lower than 17.86% in thecontrol group (P<0.05). The re-examination 3 months after operation showed that there were 8 cases (14.29%) of endo-metrial polyps recurrence in the observation group, which was slightly less than 13 cases (23.21%) in the control group,but the difference was not statistically significant (P>0.05). Conclusion Mirena combined with TCRP in the treatmentof endometrial polyps can reduce the inflammatory reaction of patients, with significant clinical efficacy and good safety,which has clinical application value.
      【Key words】 Endometrial polyps; Transcervical resection of polyp (TCRP); Mirena; Interleukin-6; Interleu-kin-10; Sex hormones; Curative effect