| The purpose of our research is to observe the expression of estrogen receptoraand changes of AFS on patients who got intrauterine adhensions and treated with different dose of external estrogen after the surgery. We hope to find the relations between them and guide the clinical medication of estrogen on patients after the sugery of intrauterine adhesion separation.Methods:90patients with moderate IUA, according to the different exogenous estrogen dose were randomly divided into three groups. Group1:caused by intrauterine adhesions after separation technique (TCRA) give pentanoic acid estradiol3mg/d three cycles; Group2:TCRA postoperatively pentanoic acid estradiol6mg/d three cycles; Group3: TCRA postoperatively pentanoic acid estradiol9mg/d three cycles. All patients for the first time in TCRA intraoperative and3times after menstrual clean review hysteroscopy surgery in adhesion tissue by detecting the expression of ER alpha intrauterine membrane. At the same time record two operations caused by intrauterine adhesions AFS grading. By comparing statistical methods:1) the expression of ER alpha before and after treatment in group three.2)3groups the expression of ER alpha expression quantity after treatment between the situation.3) according to the change of AFS score, if falling as effective, constant or rising as invalid, the comparison between the3groups (AFS value-AFS) before treatment after treatment of the averages, to investigate the relationship between the doses of estrogen and clinical prognosis.4) by comparing the three groups between before and after the treatment efficient and expression of ER alpha, infer the degree of AFS score between the three groups after to intrauterine membrane correlation of ER alpha expression.Results:1, The difference of the expression of ER alpha:3mg/d group (1.05+0.15) is lower than before treatment (1.30+0.38) after treatment, the difference was statistically significant (p<0.05);6mg/d group (1.77+0.39) is lower than before treatment (2.18+0.36) after treatment, the difference was statistically significant (p<0.05);9mg/d (1.82+0.28) is lower than before treatment (2.33+0.38) after treatment, the difference was statistically significant (p<0.05).2, Through Kruskal-Waills inspection result of the Test:three groups after treatment between the expression of ER alpha difference was statistically significant (chi-square=51.89, P<0.05); Through the SNK method compared between two groups, the expression quantity of3mg/d group was obviously lower than6mg/d and9mg/d group.3, Through Kruskal Waills inspection result of the Test:AFS score difference between the three groups of the mean difference was statistically significant (chi-square=21.88, P<0.05), through the SNK method compared between two groups:the tip of AFS rating of3mg/d group reduced significantly lower than other two groups.4, According to the correlation, the correlation coefficient of three groups, respectively,3mg/d groups:0.48,6mg/d groups:0.71,9mg/d groups:0.37. Three groups were less than zero, AFS score after treatment with ER alpha negatively correlated to the expression in the endometrium.Conclusion:1. Exogenous estrogen increased caused by intrauterine adhesions in patients with endometrial ER alpha rise in expression.6mg/d, and9mg/d group of more than3mg/d dose group can raise the expression of endometrial ER alpha within.2.6mg/d, and9mg/d group than3mg/d of treatment dose in the clinical treatment of effectiveness is higher.3. AFS score changes after treatment with caused by intrauterine adhesions in patients with endometrial ER alpha negative correlation expression, shows no correlation between the expression of ER alpha and clinical prognosis. |
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