地诺孕素与曼月乐治疗子宫腺肌病疗效及对患者血清CA125、CA199、MIS、PGF2a影响

Effect of dienogest and mirena for treating patients with adenomyosis and their influence on the levels of serum carbohydrate antigen 125,carbohydrate antigen 199,mullerianin hibiting substance,and prostaglandin F2a

目的:探讨地诺孕素与曼月乐治疗子宫腺肌病(AM)疗效及对患者血清糖类抗原125(CA125)、血清糖类抗原199(CA199)、苗勒氏管抑制物(MIS)、前列腺素F2a(PGF2a)水平的影响。方法:选取连云港市妇幼保健院与徐州医科大学附属连云港医院2020年1月-2022年1月收治的AM患者129例,按照随机数字表法分为两组,分别给予口服地诺孕素(65例,地诺孕素组)或宫内放置曼月乐(64例,曼月乐组)治疗。观察两组治疗后临床疗效,血清CA125、CA199、MIS、PGF2a水平,血液流变学,子宫内膜厚度及子宫体积变化,不良反应。结果:治疗后,地诺孕素组总有效率(96.9%)高于曼月乐组(87.5%),血清CA125、CA199、PGF2a水平均低于曼月乐组,MIS高于曼月乐组;收缩期峰值流速、舒张末期流速均低于曼月乐组,阻力指数高于曼月乐组,子宫体积(90.34±3.47 cm^(3))、子宫内膜厚度(8.56±1.22 mm)均低于曼月乐组(101.33±3.87 cm3、9.04±1.22 mm)(均P<0.05);总不良反应情况(56.9%)与曼月乐组(56.3%)无差异(P>0.05)。结论:地诺孕素与曼月乐治疗AM均可改善临床症状,但地诺孕素治疗效果更佳。

Objective:To investigate the effect of dienogest and mirena for treating patients with adenomyosis(AM)and their influence on the levels of serum carbohydrate antigen 125(CA125),carbohydrate antigen 199(CA199),mullerianin hibiting substance(MIS),and prostaglandin F2a(PGF2a)of the patients.Methods:A total of 129patients with AM who had admitted to hospital were selected as the research objects from January 2020to January 2022.According to random number table method,these patients were divided into two groups.65patients in the observation group were treated with dinorgestrol and 64patients in the control group were treated with mirena.The clinical efficacy,the levels of serum CA125,CA199,MIS,and PGF2a,the hemorheology value,the endometrial thickness,the uterine volume change,and the adverse reactions rate of the patients in the two groups after treatment were observed.Results:After treatment,the total effective rate(96.9%)of the patients in the observation group was significantly higher than that(87.5%)of the patients in the control group.The levels of serum CA125,CA199,and PGF2aof the patients in the observation group were significantly lower than those of the patients in the control group.The MIS level of the patients in the observation group was significantly higher than that of the patients in the control group.The values of peak systolic velocity and the end-diastolic velocity of the patients in the observation group were significantly lower than those of the patients in the control group.The uterine volume(90.34±3.47cm^(3))and the endometrial thickness(8.56±1.22mm)of the patients in the observation group were significantly lower than those(101.33±3.87cm3 and 9.04±1.22mm)of the patients in the control group(all P<0.05).There was no significant difference in the total adverse reactions rate(56.9%vs.56.3%)of the patients between the two groups(P>0.05).Conclusion:Both dinorgestrel and mirena for treating the patients with AM can improve their clinical symptoms,but dinorgestrel has the better effect.