地诺孕素对子宫内膜异位症患者术后子宫动脉血流动力学及骨代谢指标的改善研究

doi:10.3969/j.issn.1001-8131.2025.03.006

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Abstract Objective To investigate the effects of dienogest on uterine artery hemodynamics and bone metabolism indicators in patients with endometriosis after surgery. Methods 115 patients with endometriosis treated in our hospital were selected as the study subjects.They were randomly divided into two groups using a blind selection method.The control group received a leuprorelin acetate treatment regimen,while the observation group was treated with dienogest in addition to leuprorelin acetate.The clinical efficacy,bone mineral density(BMD)and bone metabolism indicators,hemodynamic parameters,Visual Analogue Scale(VAS)scores,pain-related stress factor levels,and adverse reactions were compared between the two groups. Results In the observation group,2 cases did not complete the full course of medication,and 1 case had missing data.In the control group,1 case had incomplete data,and 1 case withdrew midway.Therefor,55 cases in each group were finally included in the study.The total clinical effective rate in the observation group was 94.55%,significantly higher than that in the control group(P<0.05).After treatment,the observation group showed higher lumbar spine BMD(1.15±0.05 g/cm³),femoral trochanter BMD(1.11±0.05 g/cm³),DGP(29.44±3.69 ng/mL),and BALP(10.65±1.03 μg/L)levels compared to the control group,while the β-CTX level(0.44±0.11 ng/mL)was significantly lower(P<0.05).Post-treatment,the maximum blood flow velocity of the left uterine artery in the observation group(37.45±3.32 cm/s)was higher than that in the control group,and the pulsatility and resistance indices were lower.Similarly,the maximum blood flow velocity of the right uterine artery in the observation group(41.45±3.58 cm/s)was significantly higher than that in the control group,with lower pulsatility and resistance indices(P<0.05).After treatment,the observation group had significantly lower non-menstrual lower abdominal pain scores(1.67±0.47)and dysmenorrhea scores(2.09±0.29)compared to the control group.Additionally,the levels of PGF(246.26±22.19 pg/mL)and NGF(133.94±13.18 pg/mL)in the observation group were significantly lower than those in the control group(P<0.05).The total incidence of adverse reactions in the observation group was 7.27%,significantly lower than that in the control group(P<0.05). Conclusion The combination of dienogest and leuprorelin acetate significantly improves uterine artery hemodynamics and bone metabolism indicators in patients with endometriosis,reduces pain levels,and lowers the incidence of adverse reactions.However,due to the short observation period in this study,future research should extend the observation time to more comprehensively evaluate the long-term efficacy and safety of dienogest in the treatment of endometriosis.

Key words： Dienogest Endometriosis Uterine artery hemodynamics Bone metabolism indicators Improvement

Received: 28 March 2025

PACS:

R711.32

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	Articles by authors
	Zhang Zigui
	Zhang Xungong
	Feng Linna
	Yu Tiantian

Cite this article:

Zhang Zigui,Zhang Xungong,Feng Linna, et al. Study on the Improvement of Uterine Artery Hemodynamics and Bone Metabolism Indicators in Patients with Endometriosis Treated with Dienogest Postoperatively[J]. journal1, 2025, 45(3): 22-26.

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http://www.hrbyybjb.org.cn/EN/10.3969/j.issn.1001-8131.2025.03.006 OR http://www.hrbyybjb.org.cn/EN/Y2025/V45/I3/22

[1] AL HUSSAINI H A D,ALATAWI E S E,SHABANI J A J,et al.Management of Endometriosis-Related Pain:Comparing the Effectiveness of Hormonal Therapy,Surgical Interventions,and Complementary Therapies[J].Cureus,2024,16(12):e75590.
[2] CSIRZO A,KOVACS D P,SZABO A,et al.Comparative Analysis of Medical Interventions to Alleviate Endo-metriosis-Related Pain:A Systematic Review and Network Meta-Analysis[J].J Clin Med,2024,13(22):
[3] FILINDRIS T,PAPAKONSTANTINOU E,KERAMIDA M,et al.The effect of GnRH-a on the angiogenesis of endometriosis[J].Hormones(Athens),2024,23(3):509-15.
[4] LIU M,LI Y,YUAN Y,et al.Peri-implantation treatment with TNF-alpha inhibitor for endometriosis and/or adenomyosis women undergoing frozen-thawed embryo transfer:A retrospective cohort study[J].J Reprod Immunol,2025,167(104415.
[5] GOYRI E,KOHLS G,GARCIA-VELASCO J.IVF stimulation protocols and outcomes in women with endometriosis[J].Best Pract Res Clin Obstet Gynaecol,2024,92(102429.
[6] KALAITZOPOULOS D R,BURLA L,FARKAS F,et al.The Visual Effect of a Down-Regulation With Dienogest and GnRH Analogues in Endometriosis:Lessons Learned From Two-Step Surgical Approach[J].J Minim Invasive Gynecol,2024,31(5):369-70.
[7] BLAIR H A.Relugolix/Estradiol/Norethisterone Acetate:A Review in Endometriosis-Associated Pain[J].Drugs,2024,84(4):449-57.
[8] MANGUM T,AGARWAL S K.A Podcast on Patient and Physician Perspectives on the Management of Endometriosis and Relugolix Combination Therapy[J].Adv Ther,2024,41(12):4369-76.
[9] 中国医师协会妇产科医师分会,中华医学会妇产科学分会子宫内膜异位症协作组.子宫内膜异位症诊治指南(第三版)[J].中华妇产科杂志,2021,56(12):812-824.
[10] Seiji Watanabe,Kanji Koyama.Visual Analogue Pain Scale with Convenient Digitizer[J].Anesthesiology,1989,71(3):481-485.
[11] 宋丽娜. 子宫腺肌症的MRI表现及诊断价值分析[J].基层医学论坛,2018,22(19):2709-2710.
[12] 冯力民,夏恩兰,丛捷,等.应用月经失血图评估月经血量[J].中华妇产科杂志,2001,36(1):51-51.
[13] LIAO Z,TANG S,JIANG P,et al.Impaired bone morpho-genetic protein(BMP)signaling pathways disrupt deci-dualization in endometriosis[J].Commun Biol,2024,7(1):227.
[14] NADA E S,COROLEUCA C A,COROLEUCA C B,et al.Reproductive outcome after in vitro fertilization in endometriosis-key factors and implications[J].J Med Life,2024,17(3):334-40.
[15] PLUCHINO N,FRESCHI L,WENGER J M,et al.In-novations in classical hormonal targets for endometriosis[J].Expert Rev Clin Pharmacol,2016,9(2):17-27.
[16] 梁海莹,周雪勤,胡明淼,等.地诺孕素与促性腺激素释放激素激动剂类药物治疗对子宫内膜异位症手术患者血清糖类抗原125,骨密度,雌二醇和肿块大小的影响[J].中国性科学,2023,32(3):54-58.
[17] 程佳,王红,南方,等.屈螺酮炔雌醇,地诺孕素结合手术治疗子宫内膜异位症效果及对血清雌激素和月经量影响[J].中国计划生育学杂志,2023,31(8):1893-1896.
[18] 吴雯婷,沈企隆,董婕,等.地诺孕素对改善子宫内膜异位症患者性激素水平病灶大小及临床疗效的影响[J].中国妇幼保健,2023,38(17):3199-3202.
[19] 吴磊丽,蔡华丽,孙德胜,等.超声引导穿刺硬化术联合地诺孕素治疗卵巢子宫内膜异位囊肿的疗效[J].山东大学学报:医学版,2023,61(6):65-69.
[20] MA Y,WANG W X,ZHAO Y.Dienogest in conjunction with GnRH-a for postoperative management of end-ometriosis[J].Front Pharmacol,2024,15(13):73-82.
[21] AISAKA K.[Effectiveness of bisphosphonate admini-stration during Gn-RH agonist therapy for endometr-iosis][J].Nihon Rinsho,2009,67(5):27-30.
[22] ANASTASILAKIS A D,PAPACHATZOPOULOS S,MAK-RAS P,et al.The effect of pharmacological cessation and restoration of menstrual cycle on bone metabolism in premenopausal women with endometriosis[J].Bone,2022,15(8):54-63.
[23] 罗艳,林丹玫,吴茜,等.基于网络药理学的地诺孕素治疗子宫内膜异位症的机制探讨[J].中国妇幼保健,2023,38(04):591-596.
[24] 关琼,杨爱玉,吴绪峰.子宫腺肌病患者在醋酸亮丙瑞林基础上联合左炔诺孕酮宫内节育系统或地诺孕素治疗的效果比较[J].中国医药,2023,18(1):86-90.
[25] 王温馨,王树瑜,赵烨.地诺孕素治疗子宫内膜异位症的安全性研究进展[J].实用药物与临床,2023,26(2):167-171.
[26] ADAMSON G D,HEINRICHS W L,HENZL M R,et al.Therapeutic efficacy and bone mineral density response during and following a three-month re-treatment of endometriosis with nafarelin(Synarel)[J].Am J Obstet Gynecol,1997,177(6):1413-1418.