Wright J A, Sharpe-Timms K L
Office of Laboratory Animal Medicine, University of Missouri-Columbia 65212, USA.
Fertil Steril. 1995 May;63(5):1094-100.
To evaluate the effectiveness of GnRH agonist (GnRH-a) therapy on adhesion formation and reformation in established rat models for surgically induced adhesion formation and endometriosis.
Before surgery, female Sprague-Dawley rats were injected with GnRH-a or control diluent. Six days later, rats were assigned to one of four surgical groups: [1] endometriosis, [2] endometriosis sham, [3] adhesion model, or [4] adhesion sham. Three weeks after surgery, a second-look laparotomy was performed, adhesions were scored (0 = no adhesions to 3 = severe adhesions) and mechanically disrupted, and rats received a second GnRH-a or diluent injection either analogous to their initial injection or in a crossover design. Three weeks after the second injection, rats were killed and adhesion reformation was scored. Data were evaluated using nonparameteric tests including Mann-Whitney, Kruskal-Wallis, and Friedman's tests comparing GnRH-a treatments with diluent controls.
Preoperative GnRH-a therapy reduced adhesion scores in rats with surgically induced endometriosis (mean +/- SEM; GnRH-a 1.1 +/- 0.2 versus diluent 2.2 +/- 0.2) and adhesions (GnRH-a 0.3 +/- 0.1 versus diluent 0.6 +/- 0.1). Pretreatment GnRH-a therapy did not affect adhesion scores in the endometriosis sham procedure. Combined preoperative and postoperative GnRHa therapy (GnRH-a-GnRH-a) but not postoperative GnRH-a therapy alone (diluent-GnRH-a) reduced adhesion reformation after adhesiolysis in the endometriosis model (GnRH-a-GnRH-a 1.1 +/- 0.3, diluent-GnRH-a 1.6 +/- 0.7), the endometriosis sham (GnRH-a-GnRH-a 0.7 +/- 0.2, diluent-GnRHa 1.8 +/- 0.1), and the adhesion model (GnRH-a-GnRH-a 0.3 +/- 0.2, diluent-GnRHa 1.0 +/- 0.5). No adhesions were observed in the adhesion sham group.
Gonadotropin-releasing hormone agonist therapy was successful in reducing adhesion formation and reformation. These studies suggest that GnRH-a therapy for adhesion prevention in women should be explored.
在已建立的手术诱导粘连形成和子宫内膜异位症大鼠模型中，评估促性腺激素释放激素激动剂（GnRH-a）疗法对粘连形成和再形成的有效性。
手术前，对雌性斯普拉格-道利大鼠注射GnRH-a或对照稀释剂。六天后，将大鼠分配到四个手术组之一：[1]子宫内膜异位症组，[2]子宫内膜异位症假手术组，[3]粘连模型组，或[4]粘连假手术组。手术后三周，进行二次剖腹探查，对粘连进行评分（0=无粘连至3=严重粘连）并机械性破坏，然后大鼠接受第二次GnRH-a或稀释剂注射，注射方式与初始注射相同或采用交叉设计。第二次注射后三周，处死大鼠并对粘连再形成进行评分。使用非参数检验（包括曼-惠特尼检验、克鲁斯卡尔-沃利斯检验和弗里德曼检验）评估数据，比较GnRH-a治疗组与稀释剂对照组。
术前GnRH-a疗法降低了手术诱导的子宫内膜异位症大鼠的粘连评分（平均值±标准误；GnRH-a组为1.1±0.2，稀释剂组为2.2±0.2）以及粘连（GnRH-a组为0.3±0.1，稀释剂组为0.6±0.1）。术前GnRH-a疗法对子宫内膜异位症假手术过程中的粘连评分无影响。联合术前和术后GnRH-a疗法（GnRH-a-GnRH-a）而非单独的术后GnRH-a疗法（稀释剂-GnRH-a）降低了子宫内膜异位症模型（GnRH-a-GnRH-a组为1.1±0.3，稀释剂-GnRH-a组为1.6±0.7）、子宫内膜异位症假手术组（GnRH-a-GnRH-a组为0.7±0.2，稀释剂-GnRH-a组为1.8±0.1）和粘连模型组（GnRH-a-GnRH-a组为0.3±0.2，稀释剂-GnRH-a组为1.0±0.5）粘连松解后的粘连再形成。粘连假手术组未观察到粘连。
促性腺激素释放激素激动剂疗法成功降低了粘连形成和再形成。这些研究表明，应探索GnRH-a疗法用于预防女性粘连。
