探讨曼月乐联合亮丙瑞林治疗子宫腺肌症的临床效果  

Investigation on the clinical effect of Mirena combined with leuprorelin in the treatment of uterine adenomyosis

作　　者：刘洋 LIU Yang(Department of Gynecology,Chifeng Hospital of Inner Mongolia Autonomous Region,Chifeng 024000,China)

机构地区：[1]内蒙古自治区赤峰市医院妇科,024000

出　　处：《中国实用医药》2023年第22期21-26,共6页China Practical Medicine

摘　　要：目的探讨子宫腺肌症采用左炔诺孕酮宫内节育系统(商品名:曼月乐)与亮丙瑞林联合治疗的效果。方法90例子宫腺肌症患者,依据治疗方法不同分为联合治疗组及单独治疗组,各45例。联合治疗组采用曼月乐与亮丙瑞林联合治疗,单独治疗组采用曼月乐单独治疗。比较两组子宫体积、子宫内膜厚度、子宫血流动力学指标[舒张期末期血流速度(EDV)、收缩期峰值流速(PSV)、阻力指数(RI)]、痛经程度[中文版COX痛经症状量表(CMSS)评分]、月经量[月经失血图(PBAC)评分],性激素指标[促卵泡激素(FSH)、促黄体生成素(LH)、雌二醇(E_(2))]、复发相关指标[基质金属蛋白酶-2(MMP-2)、基质金属蛋白酶-9(MMP-9)、糖类抗原125(CA125)、血管内皮生长因子(VEGF)、半胱氨酸-天冬氨酸特异性蛋白酶(Caspase-3)]、性生活质量[性生活质量调查表(SLQQ)评分],不规则出血、脱环、并发症发生情况,临床疗效,治疗满意度。结果治疗后,两组患者的子宫体积、子宫内膜厚度、EDV、PSV、CMSS疼痛程度评分、CMSS持续时间评分、PBAC评分均小于本组治疗前,RI均高于本组治疗前,且联合治疗组患者的子宫体积(168.37±12.31)cm^(3)、子宫内膜厚度(4.42±1.18)mm、EDV(7.03±1.16)cm/s、PSV(33.56±5.27)cm/s、CMSS疼痛程度评分(9.15±1.25)分、CMSS持续时间评分(9.62±1.45)分、PBAC评分(56.32±9.10)分均小于单独治疗组的(181.26±11.37)cm^(3)、(7.02±1.20)mm、(8.88±1.52)cm/s、(37.03±6.10)cm/s、(16.62±1.23)分、(16.25±1.22)分、(110.23±12.14)分,RI(0.86±0.11)高于单独治疗组的(0.73±0.18),差异具有统计学意义(P<0.05)。治疗后,两组患者的血清FSH、LH、E_(2)、MMP-2、MMP-9、CA125、VEGF水平均低于本组治疗前,血清Caspase-3水平,SLQQ性伴侣、生理因素、情感因素评分及总分均高于本组治疗前,且联合治疗组患者的血清FSH(9.14±1.02)U/L、LH(5.42±1.16)U/L、E_(2)(63.56±6.42)pmol/L、MMP-2(51.66±2.60)ng/L、MObjective To discuss the effect of levonorgestrel intrauterine system(trade name:Mirena)combined with leuprorelin in the treatment of uterine adenomyosis.Methods A total of 90 patients with uterine adenomyosis were divided into combined treatment group and single treatment group according to different treatment methods,with 45 cases in each group.The combined treatment group was treated with Mirena and leuprorelin,and the single treatment group was treated with Mirena alone.Both groups were compared in terms of uterine volume,endometrial thickness,uterine hemodynamic indices[end-diastolic velocity(EDV),peak systolic velocity(PSV),resistance index(RI)],dysmenorrhea degree[Cox Menstrual Symptom Scale(CMSS)score],menstrual volume[pictorial blood loss assessment chart(PBAC)score],sex hormone indicators[follicle-stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E_(2))],relapse-related indicators[matrix metalloproteinase-2(MMP-2),matrix metalloproteinase-9(MMP-9),carbohydrate antigen 125(CA125),vascular endothelial growth factor(VEGF),cysteinyl aspartate specific proteasea-3(Caspase-3)],sexual life quality[Sexual Life Quality Questionnaire(SLQQ)score],irregular bleeding,ring removal,complications,clinical efficacy,and treatment satisfaction.Results After treatment,the uterine volume,endometrial thickness,EDV,PSV,CMSS severity score,CMSS duration score and PBAC score in both groups were all lower than those before treatment in this group,and RI was higher than that before treatment in this group;in the combined treatment group,the uterine volume was(168.37±12.31)cm^(3),the endometrial thickness was(4.42±1.18)mm,EDV was(7.03±1.16)cm/s,PSV was(33.56±5.27)cm/s,CMSS severity score was(9.15±1.25)points,CMSS duration score was(9.62±1.45)points and PBAC score was(56.32±9.10)points,which were lower than those of(181.26±11.37)cm^(3),(7.02±1.20)mm,(8.88±1.52)cm/s,(37.03±6.10)cm/s,(16.62±1.23)points,(16.25±1.22)points and(110.23±12.14)points in single treatment group;RI of(0.86±0.11)in the combined treatmen

关 键 词：子宫腺肌症 左炔诺孕酮宫内节育系统 亮丙瑞林 子宫体积 子宫内膜厚度 子宫血流动力学 

分 类 号：R711.71[医药卫生—妇产科学]