GnRH-a联合LNG-IUS治疗子宫腺肌症的临床效果

Clinical effect of GnRH-a combined with LNG-IUS in the treatment of adenomyosis

目的探讨性腺激素释放激素激动剂(GnRH-a)联合左炔诺孕酮宫内缓释系统(LNG-IUS)治疗子宫腺肌症的临床效果。方法选择2018年3月至2020年3月我院收治的118例子宫腺肌症患者作为研究对象,随机将其分为对照组和观察组,每组59例。对照组接受GnRH-a方案治疗,观察组接受GnRH-a联合LNG-IUS方案治疗。比较两组的临床症状改善情况,CA125、CA199、PGF-2a水平及子宫内膜胞饮突丰富率、子宫内膜胞饮突成熟率。结果治疗6个月后,观察组的临床症状控制优良率明显高于对照组,差异具有统计学意义(P<0.05)。治疗前,两组的CA125、CA199、PGF-2a水平比较,差异无统计学意义(P>0.05);治疗6个月后,两组的CA125、CA199、PGF-2a水平均低于治疗前,且观察组明显低于对照组,差异具有统计学意义(P<0.05)。治疗前,两组的子宫内膜胞饮突丰富率、子宫内膜胞饮突成熟率比较,差异无统计学意义(P>0.05);治疗6个月后,两组的子宫内膜胞饮突丰富率、子宫内膜胞饮突成熟率均高于治疗前,且观察组明显高于对照组,差异具有统计学意义(P<0.05)。结论 GnRH-a联合LNG-IUS治疗子宫腺肌症的临床效果显著,能够更有效地控制临床症状,改善CA125、CA199、PGF-2a水平以及子宫内膜胞饮突发育情况。

Objective To investigate the clinical effect of gonadotropin releasing hormone agonist(GnRH-a) combined with levonorgestrel-releasing intrauterine system(LNG-IUS) in the treatment of adenomyosis. Methods A total of 118 adenomyosis patients admitted in our hospital from March 2018 to March 2020 were selected as the study objects and randomly divided into control group and observation group, with 59 cases in each group. The control group received GnRH-a regimen, and the observation group received GnRH-a combined with LNG-IUS regimen. The improvement of clinical symptoms, the levels of CA125, CA199 and PGF-2 a, the endometrial pinocytoid enrichment rate and endometrial pinocytoid maturation rate were compared between the two groups. Results After 6 months of treatment, the excellent and good rate of clinical symptom control in the observation group was significantly higher than that in the control group, and the difference was statistically significant(P<0.05). Before treatment, there were no significant differences in the levels of CA125, CA199 and PGF-2 a between the two groups(P>0.05);after 6 months of treatment, the levels of CA125, CA199 and PGF-2 a in both groups were lower than those before treatment, and those in the observation group were significantly lower than the control group, and the differences were statistically significant(P<0.05). Before treatment, there were no statistical significances in the endometrial pinocytoid enrichment rate and endometrial pinocytoid maturation rate between the two groups(P >0.05);after 6 months of treatment, the endometrial pinocytoid enrichment rate and endometrial pinocytoid maturation rate in both groups were higher than those before treatment, and those in the observation group were significantly higher than the control group, and the differences were statistically significant(P <0.05). Conclusion GnRH-a combined with LNG-IUS has a significant clinical effect in the treatment of adenomyosis, which can more effectively control clinical symptoms, improve the levels of CA125, CA199, PGF-2 a and the endometrial pinocytoid development.