去氧孕烯炔雌醇片联合左炔诺孕酮宫内节育系统对子宫腺肌症患者子宫内膜厚度及基质金属蛋白酶的影响

Effect of Desogestreland Ethinylestradiol Tablets Combined with Levonorgestrel Intrauterine System on Endometrial Thickness and Matrix Metalloproteinases in Patients with Adenomyosis

目的探讨去氧孕烯炔雌醇片联合左炔诺孕酮宫内节育系统(LNG-IUS)治疗子宫腺肌症(AM)的临床效果.方法选取2020年1月—2021年11月我院收治的78例AM患者为研究对象,按随机数字表法分为两组,各39例.对照组采用LNG-IUS治疗,观察组在对照组基础上加用去氧孕烯炔雌醇片治疗,均持续治疗6个月.比较两组临床疗效、子宫内膜厚度、痛经程度、基质金属蛋白酶水平、不良反应.结果观察组总有效率94.87%较对照组的79.49%更高,治疗6个月后子宫内膜厚度(6.28±1.03)mm薄于对照组的(7.59±1.14)mm,疼痛视觉模拟评分(2.88±0.34)分低于对照组的(4.02±0.49)分,组间差异有统计学意义(P<0.05);观察组治疗6个月后基质金属蛋白酶(MMP)-1(3.82±0.43)ng/mL、MMP-2(56.78±5.14)ng/mL、MMP-9(64.52±5.19)ng/mL均低于对照组的(5.08±0.79)ng/mL、(62.34±5.28)ng/mL、(70.34±5.27)ng/mL,组间差异有统计学意义(P<0.05);两组不良反应发生率相比,差异无统计学意义(P>0.05).结论去氧孕烯炔雌醇片联合LNG-IUS可提高AM的治疗效果,减轻痛经程度,改善子宫内膜厚度,加快基质金属蛋白酶水平复常,且安全可靠.

Objective To explore the clinical effect of desogestreland ethinylestradiol tablets combined with levonor gestrel intrauterine system(LNG-IUS)in the treatment of adenomyosis(AM).Methods 78 patients with AM admitted to the hospital from January 2020 to November 2021 were selected as the research objects,and divided into two groups according to the random number table method,with 39 cases in each group.The control group was treated with LNG-IUS,and the observation group was additionally treated with desogestreland ethinylestradiol tablets on the basis of the control group,and the two groups were treated continuously for 6 months..The clinical efficacy,endometrial thickness,degree of dysmenorrhea,level of matrix metalloproteinase and adverse reactions were compared between the two groups.Results The total effective rate of the observation group was 94.87%,which was higher than 79.49%of the control group,after 6 months of treatment,the endometrial thickness was(6.28±1.03)mm,which was thinner than(7.59±1.14)mm of the control group,the pain visual analogue scale score was(2.88±0.34)points,which was lower than(4.02±0.49)points of the control group,and the differences between the groups were statistically significant(P<0.05);the levels of matrix metalloproteinases(MMP)-1,MMP-2 and MMP-9 in the observation group after 6 months of treatment were(3.82±0.43)ng/mL,(56.78±5.14)ng/mL and(64.52±5.19)ng/mL,respectively,which were lower than(5.08±0.79)ng/mL,(62.34±5.28)ng/mL,(70.34±5.27)ng/mL of the control group,and the differences between the groups were statistically significant(P<0.05);there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Desogestreland ethinylestradiol tablets combined with LNG-IUS can improve the therapeutic effect of AM,reduce the degree of dysmenorrhea,improve endometrial thickness,and accelerate the normalization of matrix metalloproteinase levels,which is safe and reliable.