左炔诺孕酮宫内缓释系统治疗子宫内膜增生的临床疗效及其对性激素及性激素受体的影响

Clinical efficacy and impact on sex hormones and sex hormone receptors of levonorgestrel intrauterine sustained-release system in the treatment of endometrial hyperplasia

目的探讨左炔诺孕酮宫内缓释系统治疗子宫内膜增生的临床疗效及其对性激素及性激素受体的影响。方法选取厦门市妇幼保健院2018—2020年收治的子宫内膜增生患者156例,按照随机数字表法分为对照组与观察组,各78例。对照组采用醋酸甲羟孕酮片治疗,观察组采用左炔诺孕酮宫内缓释系统治疗。比较2组子宫内膜厚度、血红蛋白、月经失血量、雌激素受体(ER)、孕激素受体(PR)、雌二醇(E_(2))、黄体酮(P)、卵泡刺激素(FSH)、黄体生成素(LH),并观察2组不良反应发生情况。结果治疗后,观察组子宫内膜厚度小于对照组,血红蛋白高于对照组,月经失血量少于对照组,ER、PR低于对照组(P<0.05)。治疗后,观察组E_(2)、P、FSH、LH低于对照组(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论左炔诺孕酮宫内缓释系统治疗子宫内膜增生的临床疗效确切,可改善临床症状和性激素及性激素受体水平,但有一定的不良反应,需加强预防。

Objective To discuss the clinical efficacy and impact on sex hormones and sex hormone receptors of levonorgestrel intrauterine sustained-release system in the treatment of endometrial hyperplasia.Methods A total of 156 cases of patients with endometrial hyperplasia were selected from 2018 to 2020 in Xiamen Maternal and Child Health Hospital,which were divided into control group and observation group according to random number table method,with 78 cases in each group.The control group was treated with progesterone tablets acetate,while the observation group was treated with levonorgestrel intrauterine sustained-release system.Endometrial thickness,hemoglobin,menstrual blood loss,estrogen receptor(ER),Progesterone receptor(PR),estradiol(E_(2)),progesterone(P),follicle stimulating hormone(FSH)and luteinizing hormone(LH)were compared between the two groups,and the incidence of adverse reactions were observed.Results After treatment,the thickness of endometrium in observation group was smaller than that in control group,and hemoglobin was higher than that in control group,menstrual blood loss was lese than that in control group,ER and PR were lower than those in control group(P<0.05).After treatment,E_(2),P,FSH and LH in the observation group were lower than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The levonorgestrel intrauterine sustained-release system is effective in the treatment of endometrial hyperplasia,which can improve the clinical symptoms and the levels of sex hormones and sex hormone receptors,however,it has certain adverse reactions and needs to be prevented.