左炔诺孕酮宫内释放系统治疗子宫腺肌病及其对卵巢功能的影响被引量：19

The role of levonorgestrel-releasing intrauterine system in the treatment of adenomyosis and the influence on ovarian function

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摘要目的探讨左炔诺孕酮宫内释放系统（levonorgestrel-releasing intrauterine system,LNG-IUS;商品名：曼月乐）治疗子宫腺肌病月经增多及痛经的临床疗效,观察其对患者卵巢功能的影响。方法对40例子宫腺肌病所致月经增多及痛经患者,于月经第4~7天放置LNG-IUS,行前后对照：分别采用PBAC及VRS法比较放置前及放置后3、6、12月月经量及疼痛评分,放置前及放置后6、12月时,分别测定月经第3天血清FSH,LH,E2水平,同时采用免疫组化链霉菌抗生物素蛋白-过氧化物酶连接（SP）法检测子宫内膜中ER、PR的表达情况。结果置LNG-IUS6个月后,38例患者月经量明显减少,PBAC法月经评分由放置前120.6±61.3分别下降为治疗后3、6、12个月时的53.1±21.8,39.6±19.8,17.6±6.7,与放置前比较差异均有统计学意义（P〈0.01）;痛经的VRS评分由治疗前的2.2±0.6下降为1.5±0.6,0.8±0.6,0.5±0.3,差异均有统计学意义（P〈0.01）;治疗后6、12个月子宫内膜ER、PR的表达均显著下降（P〈0.01）;治疗后6、12个月血清FSH、LH、E2水平分别与放置前比较,差异均无统计学意义（P〉0.01）。结论LNG-IUS治疗子宫腺肌病所致的月经多、痛经效果好,且对患者的卵巢功能无影响。 Objective： To evaluate the efficacy of a LNG - IUS for the treatment of menorrhagia, dysmenorrheal associated with adenomyosis and the influence of ovarian function. Methods ： 40 cases with menorrhagia and dysmenorrheal were treated with LNG - IUS. The menstrual blood loss and dysmenorrheal were observed in pre - and post - insertion of LNG - IUS at 3, 6, 12 months respectively . ER and PR expression in the endometrium by immunohistochemical methods , serum - levels of FSH, LH and E2 were tested in pre - and post - insertion at 6, 12 months respectively . Results： 38 women complete the study. There were significant differences between PBAC Score of menstrual blood and VRS Scores changes of menorrhagia and dysmenorrheal at baseline and 3, 6, 12 months follow - up. Those of menstrual blood dropping from 120. 6 ± 61.3 to 53. 1 ± 21.8, 39. 6 ± 19. 8, 17. 6 ±6. 7 ; Those of dysmenorrheal dropping from 2. 2 ± 0. 6 to 1.5 ± 0. 6, 0. 8 ± 0.6, 0. 5 ± 0. 3. Expressions of ER and PR were down - regulated significantly after treatment. （ P 〈 0. 01 ）. Conclusion： LNG - IUS is an effective therapy in the treatment of menorrhagia and dysmenorrheal associated with adenomyosis, with little effect on ovarian function.

作者李莉叶明康佳丽

机构地区广州市妇婴医院妇产科广州市第一人民医院妇产科

出处《中国优生与遗传杂志》 2007年第5期83-84,59,共3页 Chinese Journal of Birth Health & Heredity

关键词左炔诺孕酮宫内释放系统子宫内膜异位症卵巢功能 Levonorgestrel - releasing intrauterine system Adenomyosis Ovarian function

分类号 R711.71 [医药卫生—妇产科学]

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