左炔诺孕酮宫内节育系统治疗子宫腺肌病的临床研究  

Clinical study of levonorgestrel-releasing intrauterine system for adenomyosis

作　　者：陈彩蓉[1] 金燕[1] 周秀琴[1] 欧阳一兵[1] 覃碧芳[1] 

机构地区：[1]暨南大学医学院附属第五医院清远市人民医院妇产科,广东省清远511518

出　　处：《中国医师杂志》2011年第7期923-925,929,共4页Journal of Chinese Physician

摘　　要：目的探讨左炔诺孕酮宫内节育系统（LNG—IUS）治疗子宫腺肌病患者的临床疗效及对其卵巢功能的影响。方法观察80例子宫腺肌病患者放置LNG-IUS前、后1、3、6及12个月月经量评分、痛经程度评分、子宫大小、肝功能、血清CA125、EMAb、性激素、血糖及血脂水平变化。结果放置LNG-IUS后，痛经缓解明显，6个月内痛经症状基本消失。置环后6、12个月月经量明显减少[（40．0±15）ml、（28±7）m1]，与置环前[（200．0±60）m1]比较差异均有统计学意义（P〈0．01），血清CA125水平和EMAb阳性率较治疗前明显降低[CA125：（50．69±10．00）IU／Lvs（18．60±3．55）IU／L；EMAb：80．0％vs3．8％，P〈0．05]；置环6、12个月时，子宫体积缩小不明显，肝功能、血糖、血脂、血清促卵泡生成激素、促黄体生成素平分别与放置前比较，差异均无统计学意义（P〉0．05）。结论LNG-IUS治疗子宫腺肌病患者疗效好，不良反应少，且对其卵巢功能无明显影响。Objective To investigate the clinical efficacy of levonorgestrelreleasing intrauterine system （LNG-IUS） in the treatment of adenomyosis and the influence of ovarian function. Methods Eighty patients with adenomyosis were followed up for 0, 1, 3, 6, 12 months after treating with LNG-IUS. The menstrual blood volume, dysmenorrheal, size of uteri, CA125 and EMAb level, hepatic function, serum glucose and serum lipids were observed and evaluated. Serumlevels of FSH and LH were tested before insertion and followed up for 6, 12 months after insertion, respectively. Results After inserting LNG-IUS, dysmenorrhea was obviously alleviated, and it was significmatly decreased after 6 months. The menstrual blood volume was （ 200.0 ± 60 ） ml, （ 40. 0 ± 15 ） ml and （ 28 ±7 ） ml in 0, 6, 12 months after the insertion. Serum CA125 and positive rate of EMAb also significantly reduced [ CA125 ： （50. 69 ±10. 00） IU/L vs （ 18.60 ±3.55） IU/L;EMAb：80. 0% vs 3.8% , P 〈0. 05]. The volume of uterus reduced without significant changed （ P 〉 0.05 ）. There were little changes in the levels of hepatic function, serum glycosum, serum lipids, FSH and LH at 6 and 12 months after LNG-IUS（ P 〉 0.05 ）. Conclusions LUG-IUS is an effective and safe therapy for adenomyosis with dysmenorrheal and menorrhagia, and it has no significant effects on ovarian function.

关 键 词：左炔诺孕酮/治疗应用 宫内避孕器 子宫疾病/治疗 腺肌瘤/治疗 

分 类 号：R711.71[医药卫生—妇产科学]