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| Effects of Leuprolide Acetate Microspheres Combined with Laparoscopy on Serum TIMP-1 MMP-9 Levels and Conception Rate in Patients with Endometriosis |
| ZHANG Qiong, TENG Hui, HU Yuli, et al |
| General Hospital of Eastern War Zone of PLA, Jiangsu Nanjing 210002, China |
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Abstract Objective: To investigate the effect of pregnancy rate, serum matrix metalloproteinase-9 (MMP-9) and matrix metalloproteinase inhibitor-1 (TIMP-1) levels in endometriosis patients who were treated with leuprolide acetate microspheres and laparoscopy. Methods: 98 patients with endometriosis in our hospital (From December 2014 to March 2017) were randomly divided into the control group (n=49) and the study group (n=49) according to the treatment plan. The control group underwent laparoscopic conservative surgery. The study group was given leuprolide acetate microspheres on the basis of the control group (once / 4 weeks, a total of 6 injections). The clinical efficacy of the two groups, the sex hormone indicators before and after treatment [Luteinizing hormone (LH), progesterone (P), follicle stimulating hormone (FSH), estradiol (E2)] levels, serum MMP-9 and TIMP-1 levels, MMP-9/TIMP-1, pre-treatment and 1 month post-treatment estrogen status scores (Kupperman) and pelvic pain scores (VAS), followed up for 9 to 12 months, statistics of pregnancy rates were compared. Results: ①Clinical efficacy: The total effective rate of the study group was 93.88% (46/49) higher than that of the control group (79.59% (39/49) (P<0.05); ②Sex hormone indicators: serum LH, P after treatment The levels of FSH and E2 were lower than those before treatment, and the study group was lower than the control group (P<0.05). ③Serum MMP-9 and TIMP-1: serum MMP-9 and TIMP-1 levels and MMP after treatment -9/TIMP-1 was lower than before treatment, and the study group was lower than the control group (P<0.05); ⑤Kupperman and VAS scores: Kupperman and VAS scores were lower than those before treatment in the two groups after treatment. The study group was lower than the control group (P<0.05); ⑥Pregnancy rate: 9 months and 12 months after treatment, the pregnancy rate of the study group (36.73%, 51.02%) was higher than that of the control group (18.37%, 28.57%). (P<0.05). Conclusion: The use of leuprolide acetate microspheres combined with laparoscopic treatment of endometriosis can effectively improve serum sex hormone content, lower serum MMP-9 and TIMP-1 levels, and regulate MMP-9/TIMP-1 balance. It relieves clinical symptoms and pain, improves the overall therapeutic effect of the disease, and is conducive to improving the conception rate, which has certain positive significance for improving the prognosis of patients.
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2019, Vol. 25 
