曼月乐对子宫内膜异位症患者血清MIF的影响

Effect of levonorgestrel intrauterine sustained release system on MIF in patients with endometriosis

目的探讨左炔诺孕酮宫内缓释系统(曼月乐)对子宫内膜异位症(内异症)患者的治疗作用。方法选取复发内异症患者40例,自愿选择放置曼月乐,随访12个月,并于放置曼月乐后3、12个月随访,观察放置曼月乐前后患者疼痛视觉模拟(VAS)评分、卵巢内异症囊肿体积的变化、不良反应的发生、血清人类巨噬细胞移动抑制因子(MIF)水平等情况。结果与放置曼月乐前比较,痛经明显减轻,VAS评分以及血清MIF水平均明显下降(P<0.01)。放置后3、12个月盆腔痛的评分与放置前比较均有明显下降(P<0.05和P<0.01)。卵巢内异症囊肿体积明显缩小(P<0.01)。放置的不良反应主要为发生阴道不规则点滴出血,随着放置时间的延长而逐渐减少。结论曼月乐可有效地缓解复发性内异症疼痛症状,降低血清MIF水平,缩小卵巢内异症囊肿体积,值得临床推广。

Objective To investigate the therapeutic effect of Levonorgestrel intrauterine sustained release system(Mirena) on patients with endometriosis.Methods Forty patients with recurrent endometriosis who were voluntarily accepted the Mirena therapy were selected,and followed up at the 3 rd and the 12 th month after the placement.The pain visual analogue(VAS) score,the volume change of ovarian endometriosis cyst and the occurrence of adverse reactions as well as the level of MIF were observed before and after placement.Results Compared with those indicators before the placement,the symptoms of dysmenorrhea were remarkably alleviated and the VAS score was significantly decreased(P<0.01).The pelvic pain scores were significantly alleviated in 3 and 12 months after placement compared with those before placement(P<0.05 and P<0.01),the volume of ovarian endometriosis cyst and serum MIF level were also significantly reduced(P<0.01).The main adverse reaction was irregular vaginal bleeding,but decreased gradually with the time.Conclusion Mirena can effectively relieve the pain,decrease the serum MIF level and shrink the volume of ovarian endometriosis cyst in patients with recurrent endometriosis.At the same time,it has the characteristics of long acting time and less systemic side effects,which is worthy of clinical application.