左炔诺孕酮宫内缓释系统对增生过长子宫内膜形态计量学的影响

目的探讨左炔诺孕酮宫内缓释系统(LNG-IUS)对增生过长子宫内膜形态计量学的影响。方法用计算机图像分析系统测定增生过长子宫内膜LNG-IUS治疗前及治疗3个月后子宫内膜形态计量学参数的改变,并与子宫内膜增生过长炔诺酮治疗后的子宫内膜计量学参数相比较。结果LNG-IUS治疗前子宫内膜腺体数目、腺细胞核分裂数、间质细胞核分裂数、腺腔横切直径及腺上皮细胞高度分别为9.1±1.0、1.5±0.5、1.2±0.7、(90±14)μm、(20.4±12.1)μm,LNG-IUS置入子宫腔内3个月后,子宫内膜腺体数目、腺细胞核分裂数、间质细胞核分裂数减少、腺腔横切直径及腺上皮细胞高度减小,分别为1.6±0.8、0、0、(25±5)μm、(4.9±1.2)μm,前后比较差异有统计学意义(P均<0.05)。LNG-IUS研究组子宫内膜腺体数目、腺腔横切直径与炔诺酮对照组比较,两组差异有统计学意义(P<0.05)。LNG-IUS研究组腺上皮细胞高度较炔诺酮对照组低,但两者差异无统计学意义(P>0.05);两组中均未见到腺上皮细胞和间质细胞核分裂相。结论形态计量学研究表明ING-IUS有强烈的抗子宫内膜增殖作用,其对子宫内膜增殖抑制程度显著大于口服炔诺酮治疗。

Effect of the levonorgestrel - releasing intrauterine system for the morphometry of endometrial hyperplasia

Objective To study the effect of the levonorgestrel-releasing intrauterine system(LNG-IUS) for the morphometry of endometrial hyperplasia.Methods The morphotric parameters including endometrial hyperplasia treated with LNG-IUS before and after 3 months were measured in 20 cases by using computerized imaged analysis system and compared with the morphotric parameters of endometrial hyperplasia treated with norethisterone in 20 cases.Results After insertion of LNG-IUS,the endometrial number of glands,the number of glandular mitoses,the number of stroma mitoses,the diameter of the glandular lumen and the height of glandular epithelium were decreased(P<0.05).Comparison of the effect of LNG-IUS and norethisterone on the endometrial activity,among the indices measured,significant differences were found in the number of glands and glandular diameter(P<0.05).Conclusion By using objective morphometric treatment monitoring,it can be revealed that the LNG-IUS has a very strong restraining for endometria hyperplasia and this device shows more superior regression of hyperplasia.