Abstract:Objective: To investigate the efficacy of gonadotropin releasing hormone agonist (GnRH-a) in the treatment of endometriosis (EMS) and the effect on the level of histone 3 lysine 4 (H3K4) methylation in patients with endometriosis. Method: 96 cases of EMS patients admitted in our hospital from January 2015 to June 2016 were selected as the study subjects. All patients were treated with elective laparoscopic surgery and were randomly divided into the observation group and the control group, 48 cases in each group. The control group was treated with mifepristone after surgery, and the observation group was additionally treated with GnRH-1. The effective rate of treatment, pregnancy rate, recurrence rate, levels of follicle stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E2) were compared between the two groups. The positive rate of anti-endometrial antibody (EMAB), positive rate of angiopoietin-2 (Ang-2), H3K4 methylation, tissue inhibitor of metalloproteinase-1(TIMP-1), vascular endothelial growth factor (VEGF) and glycoprotein 125 (CA125) in the two groups were analyzed, and adverse reactions were observed. Results: The total effective rate of treatment and the pregnancy ratein the observation group were significantly higher than those in the control group (97.92% and 29.17% vs 85.42% and 10.42%) (P< 0.05), and the half-year recurrence rate was lower than that in the control group (2.08% vs 16.67%) (P< 0.05). After treatment, levels of serum FSH, LH and E2 were significantly lower in the observation group than the control group (P< 0.05). After treatment, the positive rates of EMAB and Ang-2 in the observation group were lower than those in the control group, while H3K4 methylationwas higher than that in the control group (P< 0.05). After treatment, the levels of serum TIMP-1, VEGF and CA125 were significantly lower in the observation group than the control group (P< 0.05). There was no significant difference between the two groups in the incidence of adverse reactions (10.42% vs 6.25%) (P > 0.05). Conclusion: GnRH-a is better than mifepristone in the treatment of EMS. It can significantly reduce the levels of hormone, EMAB, Ang-2, serum TIMP-1, VEGF and CA125 level and the recurrence rate. It also can improve the H3K4 methylation level and pregnancy rate, with high safety.
金凤羽. GnRH-a辅助治疗子宫内膜异位症疗效及对患者组蛋白H3K4甲基化水平的影响[J]. 河北医学, 2017, 23(6): 918-922.
JIN Fengyu. GnRH-a on Endometriosis and the Level of Histone H3K4 Methylation in Patients with Endometriosis. 河北医学, 2017, 23(6): 918-922.