左炔诺孕酮宫内节育系统治疗子宫腺肌病的临床研究

目的探讨左炔诺孕酮宫内节育系统（LNG—IUS）治疗子宫腺肌病患者的临床疗效及对其卵巢功能的影响。方法观察80例子宫腺肌病患者放置LNG-IUS前、后1、3、6及12个月月经量评分、痛经程度评分、子宫大小、肝功能、血清CA125、EMAb、性激素、血糖及血脂水平变化。结果放置LNG-IUS后，痛经缓解明显，6个月内痛经症状基本消失。置环后6、12个月月经量明显减少（40．0±15）ml、（28±7）m1]，与置环前（200．0±60）m1]比较差异均有统计学意义（P〈0．01），血清CA125水平和EMAb阳性率较治疗前明显降低CA125：（50．69±10．00）IU／Lvs（18．60±3．55）IU／L；EMAb：80．0％vs3．8％，P〈0．05]；置环6、12个月时，子宫体积缩小不明显，肝功能、血糖、血脂、血清促卵泡生成激素、促黄体生成素平分别与放置前比较，差异均无统计学意义（P〉0．05）。结论LNG-IUS治疗子宫腺肌病患者疗效好，不良反应少，且对其卵巢功能无明显影响。

Clinical study of levonorgestrel-releasing intrauterine system for adenomyosis

Objective To investigate the clinical efficacy of levonorgestrel- releasing intrauterine system (LNG-IUS) in the treatment of adenomyosis and the influence of ovarian function. Methods Eighty patients with adenomyosis were followed up for 0, 1, 3, 6, 12 months after treating with LNG-IUS. The menstrual blood volume, dysmenorrheal, size of uteri, CA125 and EMAb level, hepatic function, serum glucose and serum lipids were observed and evaluated. Serum- levels of FSH and LH were tested before insertion and followed up for 6, 12 months after insertion, respectively. Results After inserting LNG-IUS,dysmenorrhea was obviously alleviated, and it was significantly decreased after 6 months. The menstrual blood volume was (200. 0 ±60)ml, (40. 0 ± 15)ml and (28 ±7)ml in 0, 6, 12 months after the insertion.Serum CA125 and positive rate of EMAb also significantly reduced CA125: (50. 69 ± 10. 00) IU/L vs (18. 60 ±3.55)IU/L;EMAb:80. 0% vs 3. 8%, P ＜0. 05]. The volume of uterus reduced without significant changed (P ＞0. 05). There were little changes in the levels of hepatic function, serum glycosum, serum lipids, FSH and LH at 6 and 12 months after LNG-IUS(P ＞ 0. 05). Conclusions LUG-IUS is an effective and safe therapy for adenomyosis with dysmenorrheal and menorrhagia, and it has no significant effects on ovarian function.