左炔诺孕酮宫内缓释系统治疗无排卵性功能失调性子宫出血的效果及对PDW、ET-1水平的影响  

Clinical Effect of Levonorgestrel Releasing Intrauterine System on Anovulatory Dysfunctional Uterine Bleeding and its effect on PDW and ET-1 Levels

作　　者：兰瑞红[1] 龚护民[1] 杨扬[1] LAN Ruihong;GONG Humin;YANG Yang(Department of Obstetrics and Gynecology,Hainan Provincial People＇s Hospital,Haikou 570000,Chin)

机构地区：[1]海南省人民医院妇产科,海口570000

出　　处：《解放军预防医学杂志》2018年第7期886-889,共4页Journal of Preventive Medicine of Chinese People's Liberation Army

基　　金：海南省自然科学基金面上项目(No.2017A1121)

摘　　要：目的探讨左炔诺孕酮宫内缓释系统(曼月乐)治疗无排卵性功能失调性子宫出血的效果及对血小板分布宽度(PDW)、血管内皮素-1(ET-1)水平的影响。方法选取2015年3月-2017年12月我院收治的无排卵性功能失调性子宫出血患者82例,根据治疗方法不同分为对照组和观察组。对照组患者采用常规对症治疗,观察组患者采用常规对症治疗+左炔诺孕酮宫内缓释系统治疗,分析两组患者治疗后的临床效果。结果治疗前,两组患者子宫内膜厚度、月经量水平比较,差异无统计学意义(P>0.05);治疗后,观察组患者子宫内膜厚度、月经量水平低于对照组,差异有统计学意义(P<0.05)。治疗前,两组患者雌二醇(E2)、促卵泡生成素(FSH)、孕酮(P)、血红蛋白(Hb)、PDW、纤维蛋白原(FBG)、瘤坏死因子-α(TNF-α)、ET-1、一氧化氮(NO)水平比较,差异无统计学意义(P>0.05);治疗后,观察组患者P、Hb、PDW、FBG水平高于对照组,E2、TNF-α、ET-1、NO水平低于对照组,但FSH水平与对照组比较,差异无统计学意义(P>0.05)。两组的不良反应发生率比较,差异无统计学意义(P<0.05)。结论左炔诺孕酮宫内缓释系统治疗无排卵性功能失调性子宫出血可减少子宫内膜厚度,改善性激素水平和血小板活性,降低月经量和ET-1水平,且安全性高。Objective To explore the therapeutic effect of the levonorgestrel releasing intrauterine system on anovulatory dysfunctional uterine bleeding and its effect on platelet distribution width（ PDW） and endothelin-1（ ET-1） levels.Methods Between March 2015 and December 2017,82 patients with anovulation dysfunctional uterine bleeding were selected and divided into the control group and observation group according to treatment methods. The patients in the control group were treated with the conventional symptomatic therapy,while those in the observation group were treated with the routine therapy plus the levonorgestrel releasing intrauterine system. The clinical effects of the two groups were analyzed. Results Before treatment,there was no significant difference in the endometrial thickness or menstrual volume between the two groups（ P〈0.05）. After treatment,the endometrial thickness and menstrual volume in the observation group were lower than those in the control group（ P〈0.05）. Before treatment,the difference in the levels of estradiol（ E2）,follicle-stimulating hormone（ FSH）,progesterone（ P）,hemoglobin（ Hb）,PDW,fibrinogen（ FBG）,tumor necrosis factor alpha（ TNF alpha）,ET-1 and nitric oxide（ NO） of the two groups was not of statistic significance（ P〉0.05）. After treatment,the levels of P,Hb,PDW and FBG in the observation group were higher than those of the control group,while the levels of E2,TNF-,ET-1 and NO were lower than those of the control group,but the level of FSH was not significantly different compared with the control group（ P〉0.05）. There was no significant difference in the incidence of adverse reactions between the two groups（ P 〈0. 05）. Conclusion The treatment of ovulatory dysfunctional uterine bleeding with the levonorgestrel releasing intrauterine system can reduce the thickness of the endometrium,improve the level of sex hormones and platelets,reduce the amount of menstruation and ET-1,and is quite safe.

关 键 词：左炔诺孕酮宫内缓释系统 无排卵性功能失调性子宫出血 血小板分布宽度 血管内皮素-1 性激素 

分 类 号：R711.52[医药卫生—妇产科学]