生长激素对重度宫腔黏连患者的治疗效及对妊娠结局和炎性细胞因子的影响
[摘要] 目的 探討生长激素对重度宫腔黏连患者的治疗效果及对妊娠结局和炎性细胞因子水平的影响。 方法 选取2014年6月～2017年3月右江民族医学院附属医院妇产科诊治的66例重度宫腔黏连患者为研究对象，按照是否使用生长激素将患者分为对照组（宫腔粘连分离术+雌激素治疗）+观察组（宫腔粘连分离术+雌激素+生长激素干预），每组各33例。比较两组患者的临床治疗效果和妊娠结局，应用酶联免疫吸附试验测定炎性细胞因子白细胞介素-6（IL-6）、白细胞介素-8（IL-8）和肿瘤坏死因子-α（TNF-α）的变化水平。 结果 观察组患者的月经改善率明显高于对照组（χ2=4.232，P=0.039），且宫腔再黏连率也明显低于对照组（χ2=3.995，P=0.046）；观察组患者的试孕成功率明显高于对照组（χ2=3.986，P=0.046），但两组不良反应发生率比较，差异无统计学意义（χ2=0.733， P=0.392）；观察组患者的子宫内膜厚度明显高于对照组（P < 0.05），但两组患者子宫内膜容积、阻力指数和搏动指数比较，差异无统计学意义（P > 0.05）。治疗后观察组患者的IL-6、IL-8和TNF-α水平均明显低于对照组，差异均有统计学意义（P < 0.05）。 结论 生长激素可显著提高宫腔黏连患者的治疗效果，改善妊娠结局，降低炎性细胞因子水平。
[关键词] 生长激素；重度宫腔黏连；细胞因子；妊娠结局
[中图分类号] R711 [文献标识码] A [文章编号] 1673-7210（2018）02（c）-0084-04
Effect of growth hormone in the treatment of patients with severe intrauterine adhesions and its effect on the outcome of pregnancy and the level of inflammatory cytokines
YANG Li WU Huizhen GAN Haisi
Department of Obstetrics and Gynecology， Affiliated Hospital of Youjiang Medical University for Nationalities， Guangxi Zhuang Autonomous Region， Baise 533000，China
[Abstract] Objective To investigate the effect of growth hormone on the treatment of patients with severe intrauterine adhesions and its effect on the outcome of pregnancy and the level of inflammatory cytokines. Methods Sixty-six patients with severe intrauterine adhesions treated in Obstetrics and Gynecology of Affiliated Hospital of Youjiang Medical University for Nationalities from June 2014 to March 2017 were selected as study subjects， and all patients were divided into control group （intrauterine adhesions separation surgery + estrogen therapy） + observation group （intrauterine adhesions separation + estrogen + growth hormone intervention） according to whether usedgrowth hormone， each group had 33 cases. The clinical treatment effect and pregnancy outcomes were compared between two groups， the levels of inflammatory cytokines interleukin-6 （IL-6）， interleukin-8 （IL-8） and tumor necrosis factor-α （TNF-α） were measured by enzyme linked immunosorbent assay. Results The improvement rate of menstruation in the observation group was significantly higher than that in the control group （χ2=4.232， P=0.039）， and the intrauterine readhesion rate was also significantly lower than that in the control group （χ2=3.995， P=0.046）. The pregnancy success rate was significantly higher than that of the control group （χ2=3.986， P=0.046）， but there was no significant difference in the incidence of adverse reactions between the two groups （χ2=0.733， P=0.392）. The endometrial thickness of the observation group was significantly higher than that of the control group （P < 0.05）. However， there was no significant difference in endometrial volume， resistance index and pulsatility index between the two groups （P > 0.05）. In addition， the levels of IL-6， IL-8 and TNF-α in the observation group were significantly lower than those in the control group after the treatment （P < 0.05）. Conclusion Growth hormone can significantly improve the treatment of patients with intrauterine adhesions， improve pregnancy outcomes， reduce the level of inflammatory cytokines.