GnRH-a联合LNG-IUS对子宫腺肌病患者痛经、月经及血清CA125表达的影响

Effect of GnRH-a Combined with LNG-IUS on Dysmenorrhea,Menstruation and Serum CA125 Expression in Patients with Adenomyosis

目的:探讨促性腺激素释放激素激动剂(Gn RH-a)联合左炔诺孕酮宫内释放系统(LNG-IUS)对子宫腺肌病(AM)患者痛经、月经及血清CA125表达的影响,以更好地指导临床治疗AM。方法:选取2016年1月-2017年1月本院收治的AM患者80例。按照治疗方法不同将其分为对照组(GnRH-a治疗)和观察组(GnRH-a联合LNG-IUS治疗),各40例。比较观察组治疗前后的子宫体积、CA125水平;比较两组治疗后6个月痛经程度、子宫体积、月经量评分、CA125水平。结果:治疗后,两组子宫体积均小于治疗前,CA125水平均低于治疗前,且观察组子宫体积均小于对照组,CA125水平均低于对照组,比较差异均有统计学意义(P<0.05);治疗后6个月,观察组痛经VAS评分、子宫体积、月经量评分、CA125水平分别为(0.68±0.19)分、(133.28±22.89)cm^3、(18.95±10.40)分、(39.36±8.88)U/m L,均低于对照组的(1.89±0.55)分、(190.30±28.35)cm^3、(43.40±11.35)分、(78.25±18.30)U/m L,比较差异均有统计学意义(P<0.05)。结论:AM患者接受GnRH-a+LNG-IUS联合治疗,有助于减轻患者疼痛症状,降低血清CA125含量,同时还能减少AM囊肿的体积,安全可靠,副反应低,可以在临床推荐使用。

Objective：To explore the effect of gonadotropin releasing hormone agonist（GnRH-a） combined with levonorgestrel intrauterine release system（LNG-IUS） on dysmenorrhea,menstruation and serum CA125 expression in patients with adenomyosis（AM）,in order to better guide the clinical treatment of AM.Method：A total of 80 patients with AM in our hospital from January 2016 to January 2017 were selected.According to different treatment methods,they were divided into control group（GnRH-a treatment） and observation group（GnRH-a combined with LNG-IUS treatment）,40 cases in each group.The uterine volume and CA125 level of observation group before and after treatment were compared,the dysmenorrhea degree,uterine volume,menstrual volume score and CA125 level after treatment 6 months between two groups were compared.Result：After treatment,the uterine volume of two groups were smaller than those of before treatment,the CA125 level were lower than those of before treatment,and the uterine volume of observation group were smaller than that of control group,the CA125 level were lower than that of control group,the differences were statistically significant（P〈0.05）.After treatment 6 months,the VAS score of dysmenorrhea,uterine volume,menstrual volume score and CA125 levels in observation group were（0.68±0.19）points,（133.28±22.89）cm3,（18.95±10.40）points,（39.36±8.88）U/m L were all lower than（1.89±0.55）points,（190.30±28.35）cm3,（43.40±11.35）points,（78.25±18.30）U/m L in control group,the differences were statistically significant（P〈0.05）.Conclusion：AM patients receiving GnRH-a＋LNG-IUS combined therapy can help relieve pain symptoms,reduce serum CA125 content,also reduce the volume of AM cysts,safe and reliable,low side reaction,can be recommended in clinical use.