使用国产长效避孕皮下埋植剂妇女五年内血清雌二醇、孕酮、左旋18甲基炔诺酮水平

Changes in Serum Estradiol ,Progesterone and Levonorgestrel Levels in Women during Five Years after Insertion of Sino-implant

５例使用国产长效避孕皮埋剂（Ｓｉｎｏ－Ｉｍｐｌａｎｔ，以下简称为Ｓｉｎｏ）长达五年以上的妇女，每年末抽血一个周期（即连续４～５周，每周定时抽血一次）。用ＲＩＡ测定血清中雌二醇（Ｅ２），孕酮（Ｐ）和左旋１８甲基炔诺酮（ＬＮＧ）水平。研究结果显示：长期使用Ｓｉｎｏ未出现相似的卵巢内分泌反应。８４％（２１／２５）抽血周期血清Ｅ２水平出现峰值（Ｅ２＞１５０ｐｇ／ｍｌ），以例数计，埋植后１～４年内每年有８０％（４／５）抽血周期血清中Ｅ２显示峰值，第五年为１００％（５／５）。４０％（１０／２５）抽血周期显示黄体活性（Ｐ＞３ｎｇ／ｍｌ），以例数计，埋植第一年为０％（０／５）；第二年为４０％（２／５）；３～５年每年６０％（３／５）表现黄体活性。５例对象中有２例埋植后五年内未见血清Ｐ＞１ｎｇ／ｍｌ，而且这２例分别在埋植后１～２年及３～４年未见Ｅ２峰（Ｅ２＜１５０ｐｇ／ｍｌ）。５例对象埋植前对照周期均有正常的Ｅ２峰和黄体活性。在用Ｓｉｎｏ的５年内抽血周期血清Ｅ２和Ｐ的均值都低于对照周期。在用Ｓｉｎｏ期间，有黄体活性的周期均伴有Ｅ２峰。然而，并非所有有Ｅ２峰的周期都表现黄体活性。在埋植第一年，除第一个月外，血清ＬＮＧ水平低而相对?

Five women had the Sino - Implant inserted five years. Blood Samples were taken once a week for four or five consecutive weeks during each last cycle within 1～5 years after insertion every year. The serum concentrations of Estradiol (E2), Progesterone (P) and Levonorgestrel (LNG) were measured in each sample by RIA. The results of present study showed that, the implant users had the different ovarian endocrine response to the continuous LNG exposure.All controls cycles had normal E2 peak and luteal activity,the mean E2 and P level were lower in the Sino - Implant runs as compared with the controls cycles.Eighty - four percent of the observed sampling cycles (21/25) had E2 peaks (E2>150 pg/ml). The proportion of sampling runs with E2 peak increased from 80% (4/5) in the 1st～4th years of use every to 100% (5/5) during the sib year of use.Forty - four percent of the sampling runs had luteal activity which increased from 40% (2/5) during the first two years of use to 60% (3/5) during the third,fourth and fifth year of use.All Sino - implant sampling runs with luteal activity had fluctuating E2 levels. However,not all cycles with normal E2 levels showed luteal activity.During the first year after insertion blood levels of LNG stabilized at 0. 26±11 ng/ml except for the first cycle. During the 5th year serum LNG levels were 0. 21±0. 08 ng/ml on an average,i. e,the average LNG levels in sib year were 20% lower than those in first year. Meanwhile significant individual difference in the LNG levels was observed.In summary the results of the present study showed that women using Sino - Implant had ovarian activity in varying degress,which became closer to normal during the 4th and 5th year after insertion.