左炔诺孕酮宫内系统临床使用五年的安全性研究  

Clinical study on women with amenorrhea after levonorgestrel intrauterine system

作　　者：张莉嘉[1] 翁梨驹[1] 

机构地区：[1]首都医科大学附属北京朝阳医院妇产科,100020

出　　处：《中华妇产科杂志》2001年第11期675-677,共3页Chinese Journal of Obstetrics and Gynecology

摘　　要：目的　观察左炔诺孕酮宫内系统 (LNG IUS)临床使用 5年的抗生育效果、副反应及探讨其使用的安全性。方法　对 10 0例经产妇 ,随机放置LNG IUS(LNG组 )和宫内节育器TCu380A(TCu组 )各 5 0例 ,定期随访。对 14例闭经者测定血清生殖激素水平及对 9例闭经者进行子宫内膜病理学检查。结果　TCu组 2例妊娠 ;LNG组无妊娠发生 ,因闭经停用 2 4例。 5年末续用率LNG组为2 4 0 % ,TCu组为 74 0 % (P <0 0 0 1)。 14例闭经者生殖激素水平与对照组相比 ,差别无显著性 (P >0 0 5 )。LNG组子宫内膜病理检查为内膜萎缩、少数腺体分泌现象。结论　LNG IUS导致的闭经是药物对子宫内膜的局限性抑制作用 ,是可逆的 ,对卵巢功能影响不大 ,卵巢仍能正常分泌激素。LNG IUS是一种可长期使用、低妊娠率、安全的避孕系统。Objective To study the 5 years contraceptive efficacy of levonorgestrel intrauterine system (LNG-IUS) and the ovarian functions in amenorrhea women. Methods LNG-IUS and TCu 380A IUD were randomly inserted in 2 groups of women, 50 each. Women were followed annually for 5 years. Serum follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), estradiol (E 2), and T levels in 14 women with amenorrhea, and endometrial biopsies were obtained in 9 cases. Results By the end of 5 years, there were 2 pregnancies in TCu 380A group, but none in LNG-IUS group; and 24 amenorrhea cases in LNG-IUS. The 5 year cumulative continuation rates were 24% for LNG-IUS and 78% for TCu 380A ( P <0.001). In the 14 women with amenorrhea, the average serum concentrations were not significantly different from that of the normal controls. Histological study showed endometrial atrophy or a few secretory glands. Conclusions LNG-IUS is a highly effective and safe contraceptive measure. Oligomenorrhea and amenorrhea caused by the local effects of LNG were reversible and did no harm to women′s health. However, comprehensive consultation provided to women before insertion is of utmost importance for continuation use.

关 键 词：左炔诺孕酮 避孕药 用药安全 临床研究 

分 类 号：R169.41[医药卫生—公共卫生与预防医学] R979.21