左炔诺孕酮宫内缓释系统与长效醋酸甲羟孕酮治疗子宫内膜异位症的临床疗效

Clinical efficacies of levonorgestrel-releasing intrauterine system and depot medroxyprogesterone acetate for treatment of endometriosis

目的:比较左炔诺孕酮宫内缓释系统(LNG-IUS)与长效醋酸甲羟孕酮(Depot-MPA)治疗子宫内膜异位症的临床疗效。方法:保守性手术后即刻或单纯疼痛复发后患者87例,42例放置LNG-IUS,45例在3年内每隔3个月肌注长效醋酸甲羟孕酮(Depot-MPA)150 mg,比较临床症状控制情况、复发率、依从性、骨密度。结果:两种治疗方案均能控制临床疼痛症状及复发率。LNG-IUS治疗组患者依从性优于长效醋酸甲羟孕酮治疗组。LNG-IUS治疗组腰椎及股骨颈Wards三角区骨密度(BMD)变化幅度比长效醋酸甲羟孕酮治疗组大。结论:LNG-IUS治疗组可以有效地控制子宫内症膜异位症的临床症状和复发率,患者依从性好,骨密度可以得到改善,而长效醋酸甲羟孕酮治疗组出现骨密度下降。

Objective： To compare the clinical efficacies of levonorgestrel -releasing intrauterine system （LNG -IUS） and depot medroxyprogesterone acetate for treatment of endometriosis. Methods： Eighty - seven patients with immediate pain or recurrence of simple pain after conservative surgery were selected, 42 cases received LNG - IUS, and 45 cases were treated with intramuscular injection of depot medroxyprogesterone acetate （150 mg） every three months within three year; the controlling situations of clinical symptoms, recurrence rates, compliances, and bone mineral densities in the two groups were compared. Results： Both the two therapeutic schemes could control clinical symptoms and recurrence rate ; the compliance of patients in LNG - IUS group was better than that in depot medroxyprogesterone ace- tate group; the change amplitudes of bone mineral densities of lumbar vertebrae and Wards trigonum of collum femoris in LNG - IUS group were larger than those in depot medroxyprogesterone acetate group. Conclusion： LNG - IUS can effectively control clinical symptoms and re- currence rate of endometriosis, the compliance of patients is good, and bone mineral density is improved, while in depot medroxyprogesterone acetate group, bone mineral density decreases.