中文摘要：

目的：探讨促性腺激素释放激素激动剂（GnRH-a）辅助治疗子宫内膜异位症（EMS）疗效及对患者组蛋白3赖氨酸4（H3K4）甲基化水平的影响.方法：选取2015年1月至2016年6月我院收治的EMS患者96例为研究对象,均择期行腹腔镜手术,随机分为观察组、对照组各48例,对照组术后给予米非司酮,观察组在此基础上予以GnRH-1,比较两组治疗有效率、妊娠率、复发率及治疗前后卵泡激素（FSH）、黄体生成素（LH）、雌二醇（E2）,分析两组抗子宫内膜抗体阳性率（EMAB）、血管生成素-2阳性率（Ang-2）、H3K4甲基化、基质金属蛋白酶抑制剂-1（TIMP-1）、血管内皮生长因子（VEGF）、糖蛋白125（CA125）,同时观察不良反应.结果：观察组治疗有效率97.92%、妊娠率29.17%明显高于对照组85.42%、10.42%（P〈0.05）,半年内复发率2.08%低于对照组16.67%（P〈0.05）;观察组治疗后血清FSH、LH、E2较对照组明显降低（P〈0.05）;治疗后观察组EMAB阳性率31.25%、Ang-2阳性率33.33%低于对照组,H3K4甲基化（0.21±0.07）%高于对照组（0.16±0.04）%（P〈0.05）;治疗后观察组血清TIMP-1（35.29±1.35）ng/mL、VEGF（121.19±1.56）pg/mL、CA125（19.23±1.67）U/mL较对照组显著下降（P〈0.05）;两组不良反应发生率10.42%、6.25%比较无显著差异（P〉0.05）.结论：GnRH-a辅助治疗EMS疗效较米非司酮好,可显著降低患者激素、EMAB、Ang-2、血清TIMP-1、VEGF、CA125水平及复发率,提高H3K4甲基化水平及妊娠率,且安全性高,值得在临床推广应用.

英文摘要：

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）.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.