左炔诺孕酮宫内节育系统对子宫腺肌病患者细胞免疫平衡的影响分析

Influence of levonorgestrel intrauterine system on the cell immunity balance of patients with adenomyosis

目的:分析左炔诺孕酮宫内节育系统对子宫腺肌病患者细胞免疫平衡的影响。方法:选取从2015年2月至2016年4月在本院生殖科诊断为子宫腺肌病的患者共75例,并于月经结束第4~7d放置左炔诺孕酮宫内节育系统进行治疗。检测患者治疗前卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E_2)、泌乳素(PRL)水平及体内IL-6、IL-10、TNF-α水平;观察记录患者痛经评分、慢性盆腔痛评分、子宫内膜厚度及月经量。随访记录患者放置左炔诺孕酮宫内节育系统后3、6、12个月时上述指标变化。结果:患者放置左炔诺孕酮宫内节育系统后FSH、LH、E_2水平无明显变化,PRL水平显著下降(P<0.05)。所有患者痛经评分、慢性盆腔痛评分、子宫内膜厚度及月经量明显降低(P<0.05)。经治疗患者体内IL-6、TNF-α含量明显增高,IL-10明显降低(P<0.05)。结论:左炔诺孕酮宫内节育系统对治疗子宫腺肌病具有明显疗效,可帮助维持细胞免疫平衡。

Objectives： To study the influence of levonorgestrel intrauterine system on the cell immunity balance of patients with adenomyosis. Methods： 75 patients with adenomyosis in our hospital from February 2015 to April 2016 were selected. 4 ~ 7 d at the end of menstruation levonorgestrel intrauterine system was placed for treatment. Follicle stimulating hormone（ FSH）,luteinizing hormone（ LH）,estradiol（ E2）,prolactin（ PRL） level,IL-6,IL-10,and TNF-levels of patients before treatment were recorded; dysmenorrhea score,chronic pelvic pain score,endometrial thickness and menstrual volume were recorded. The patients were followed up for 3,6 and12 months after the treatment to record the above indexes. Result： The follicle stimulating hormone（ FSH）,luteinizing hormone（ LH） and estradiol（ E2） levels had no obvious change after the treatment. Prolactin（ PRL） level was significantly decreased（ P〈0. 05）. After treatment,all patients with dysmenorrhea score,chronic pelvic pain score and endometrial thickness and menstrual volume decreased significantly（ P〈0. 05）. After treatment,the levels of IL-6 and TNF-alpha in patients were significantly increased,and IL-10 was significantly reduced（ P〈0. 05）. Conclusion： Levonorgestrel intrauterine system has obvious curative effect on the treatment of adenomyosis,which can help maintain the immune balance.