航空航天医学杂志

目的 探究亮丙瑞林微球对子宫内膜异位症(endometriosis, EMS)腹腔镜术后患者血管内皮功能、卵巢功能及术后复发率的影响。方法 选择商丘市立医院妇产科在2021年01月至2024年01月期间接受腹腔镜手术的EMS患者80例，通过抽签法将其随机分为对照组和实验组，各40例。2组患者均接受标准的腹腔镜手术治疗，术后对照组患者采用孕三烯酮胶囊口服治疗，而实验组患者则接受亮丙瑞林微球注射治疗，治疗周期均为3个月。对2组患者的临床疗效、血管内皮功能、激素水平及卵巢功能进行对比分析，并跟踪观察患者在治疗结束后1年内的复发情况。结果 治疗3个月后，实验组的总疗效高于对照组(P<0.05)。治疗后，2组患者血清中血管内皮生长因子(vascular endothelial growth factor, VEGF)、血管生成素-2(Angiopoietin-2,Ang-2)含量均有所下降，且实验组较对照组更低(P<0.05);2组患者的黄体生成素(luteinizing hormone, LH)、雌二醇(estradiol, E₂)及卵泡刺激素(follicle-stimulating hormone, FSH)水平均降低，且实验组较对照组低(P<0.05);2组患者的窦卵泡计数(antral follicle count, AFC)及卵巢体积均较治疗前有所减少，但实验组AFC及卵巢体积均高于对照组(P<0.05)。随访期间，实验组EMS复发率低于对照组(P<0.05)。结论 亮丙瑞林微球作为辅助治疗手段，在EMS患者腹腔镜术后呈现出显著疗效，能够有效改善患者的血管内皮功能，调节激素水平，促进卵巢功能的恢复，并显著降低术后复发风险。

Objective To investigate the effects of leuprorelin microspheres on vascular endothelial function, ovarian function, and postoperative recurrence rate in patients with endometriosis(EMS) after laparoscopic surgery. Methods A total of 80 patients with EMS who underwent laparoscopic surgery in the Department of Obstetrics and Gynecology, Shangqiu Municipal Hospital from January 2021 to January 2024 were selected for the study. They were randomly divided into a control group and an experimental group by drawing lots, with 40 cases in each group. Both groups of patients received standard laparoscopic surgery. After surgery, the control group was treated with oral gestrinone capsules, while the experimental group was injected with leuprorelin microspheres. All were treated for 3 months. Comparisons were made between the two groups on clinical efficacy, vascular endothelial function, hormone levels, ovarian function, and recurrence within one year after the end of treatment. Results After 3 months of treatment, the total effective rate of the experimental group was higher than that of the control group(P<0.05). After treatment, the levels of vascular endothelial growth factor(VEGF) and angiopoietin-2(Ang-2) in the serum of both groups of patients decreased, and the experimental group was lower than the control group(P<0.05). The levels of luteinizing hormone(LH), estradiol(E₂) and follicle stimulating hormone(FSH) in both groups decreased, and the levels were lower in the experimental group(P<0.05). The antral follicle count(AFC) and ovarian volume of both groups of patients decreased compared to before treatment, but the AFC and ovarian volume of the experimental group were higher than those of the control group(P<0.05). During the follow-up period, the recurrence rate of EMS was lower in the experimental group than in the control group(P<0.05). Conclusions As an adjuvant therapy, leuprorelin microspheres demonstrate significant therapeutic effects on patients with EMS after laparoscopic surgery, which can effectively improve vascular endothelial function, regulate hormone levels, promote ovarian function recovery, and significantly reduce postoperative recurrence risk.