左炔诺孕酮宫内释放系统治疗子宫腺肌病的临床观察

目的:探讨左炔诺孕酮宫内释放系统(LNG-IUS;商品名:曼月乐)治疗子宫腺肌病月经过多及痛经的临床疗效。方法:对65例子宫腺肌病所致月经过多及痛经患者,于月经第4～7天放置LNG-IUS,行前后对照:于LNG-IUS放置前及放置后3、6、12个月,分别采用PBAC法及VRS法比较月经量及疼痛评分,同时分别测定血清CA125、月经第3天血清雌二醇(E2)、卵泡刺激激素(FSH)、黄体生成激素(LH)水平。结果:放置左炔诺孕酮宫内释放系统后12个月,月经量的PBAC法评分由放置前(119.6±61.0)分,分别下降为治疗后3、6、12个月时的(55.1±22.8)分、(38.4±17.8)分、(19.6±8.5)分,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±0.4)分下降为(1.3±0.6)分、(0.5±0.2)分、(0.4±0.3)分,差异均有统计学意义(P<0.01);血清CA125由治疗前的(66±21)kU/L下降为(52±20)kU/L、(35±14)kU/L、(22±11)kU/L,差异均有统计学意义(P<0.01);E2、FSH及LH与放置前比较,差异无统计学意义(P>0.05)。结论:LNG-IUS治疗子宫腺肌病所致的月经过多和痛经效果显著。

Levonorgestrel-releasing intrauterine system for treatment of adenomyosis

Objective Release of levonorgestrel intrauterine system（LNG-IUS;brand name：Mirena）in the treatment of adenomyosis with menorrhagia and dysmenorrhea clinical efficacy.Methods 65 cases of uterine adenomyosis induced menorrhagia and dysmenorrhea patients,in the period 4 to 7 days placed LNG-IUS,the line before and after comparison：in the LNG-IUS placed before and 3,6,12 months after placement,respectively,VRS by PBAC Comparison method and amount of menstruation,and pain scores,respectively,while serum CA125,menstrual day 3 serum estradiol（E2）,follicle stimulating hormone（FSH）,luteinizing hormone（LH）levels.Results Levonorgestrel intrauterine system placed 12 months after release,the amount of the PBAC law menstrual score by placing the former（119.6±61.0）decreased 3,6,12 months after the treatment time（55.1±22.8）,（38.4±17.8）,（19.6±8.5）,and placed the former were statistically significant differences（P〈0.01）;dysmenorrhea VRS score from before treatment（2.2±0.4）decreased（1.3±0.6）,（0.5±0.2）,（0.4 ±0.3）,the differences were statistically significant（P〈0.01）;serum CA125 decreased from（66±21） kU/L decreased（52±20） kU/L,（35±14） Ku/L,（22± 11） kU/L,the differences were statistically significant（P〈0.01）;E2,FSH and LH and placed before the difference was not statistically significant（P〉0.05）.Conclusion LNG-IUS treatment of adenomyosis and dysmenorrhea,menorrhagia due to significant effect.