GnRH-a联合曼月乐对子宫腺肌病患者卵巢功能、子宫体积的影响  

Effects of GnRH-a combined with mirena on ovarian function and uterine volume in patients with adenomyosis

作　　者：刘茂永 黄露[1] 龚乾涛 王丹[1] 简远丽 罗丽娜[1] Liu Maoyong;Huang Lu;Gong Qiantao;Wang Dan;Jian Yuanli;Luo Lina(Department of Gynecology and Obstetrics, The First People’s Hospital of Zunyi,Zunyi Guizhou 563000, China)

机构地区：[1]遵义市第一人民医院妇产科,贵州遵义563000

出　　处：《保健医学研究与实践》2019年第2期47-50,共4页Health Medicine Research and Practice

摘　　要：目的探讨促性腺激素释放激素激动剂(GnRH-a)联合曼月乐对子宫腺肌病患者卵巢功能、子宫体积的影响。方法本研究选取遵义市某医院2015年2月-2017年6月诊治的74例子宫腺肌病患者为研究对象,采用随机数字表法将患者分为对照组(n=37)与观察组(n=37)。2组患者均于月经周期第3天接受皮下注射GnRHa治疗。第4次注射GnRH-a后,于观察组患者子宫内放置曼月乐。治疗6个月时,比较2组患者的治疗效果及子宫体积;比较2组患者治疗前及治疗6个月时促黄体生成素(LH)、雌二醇(E2)、促卵泡激素(FSH)水平及卵巢间质动脉收缩期峰值(PSV)。结果观察组患者治疗总有效率为97.30%,高于对照组的81.08%,差异有统计学意义(P<0.05)。治疗前,2组患者FSH,LH,E2水平及PSV,子宫体积比较,差异无统计学意义(P>0.05);治疗6个月时,观察组、对照组患者FSH水平分别为(11.25±2.74) U/L及(7.72±1.11) U/L,均高于治疗前,且观察组患者高于对照组,差异有统计学意义(P<0.05);治疗6个月时,观察组、对照组患者PSV分别为(0.054±0.012)m/s及(0.075±0.016) m/s,均低于治疗前,且观察组患者低于对照组,差异有统计学意义(P<0.05);治疗6个月时,观察组、对照组患者子宫体积分别为(101.23±12.47) cm3及(214.52±18.41) cm3,均小于治疗前,且观察组患者小于对照组,差异有统计学意义(P<0.05)。结论 GnRH-a联合曼月乐治疗子宫腺肌病的疗效确切,其可调节卵巢功能,缩小子宫体积,同时提高治疗效果,临床效果显著,值得推广应用。Objective To investigate the effects of gonadotropin releasing hormone agonist (GnRH-a) combined with Mirena on ovarian function and uterine volume in patients with adenomyosis. Methods Seventy-four patients with adenomyosis who were treated at a Zunyi hospital between February 2015 and June 2017 were included in this study. Based on the use of a random number table, these patients were divided into the trial group ( n =37) or the control group ( n =37). All patients received subcutaneous injection of GnRH-a on the third day of menstruation;and intrauterine Mirena placement was performed after the 4 th GnRHa injection for patients in the trial group. At 6 months, treatment response was compared between the two groups. Besides, luteinizing hormone (LH), estradiol (E 2), follicle-stimulating hormone (FSH), ovarian stromal artery peak systolic velocity (PSV), and uterine volume at baseline and at 6 months were also compared between the two groups. Results The overall response rate in the trial group was significantly higher than that in the control group (97.30% vs. 81.08%, P <0.05). At baseline, the FSH, LH, E 2, PSV, and uterine volume were similar between the two groups ( P > 0.05). The FSH level was increased compared with baseline in both groups, greater increase in the trial group (11.25±2.74 vs. 7.72±1.11 U/L, P <0.05);the PSV was lower than that at baseline in both groups, with a significantly greater reduction in the trial group (0.054±0.012 vs. 0.075±0.016 m/s, P <0.05);the uterine volume was smaller than that at baseline in both groups, also with a significantly greater reduction in the trial group (101.23±12.47 vs. 214.52±18.41 cm 3, P < 0.05). Conclusion GnRH-a combined with Mirena has favorable efficacy in treating adenomyosis, which is effective in regulating ovarian function and reducing uterine volume. This combination therapy deserves widespread clinical application.

关 键 词：GNRH-A 曼月乐 子宫腺肌病 卵巢功能 

分 类 号：R711.71[医药卫生—妇产科学]