LNG-IUS联合戈舍瑞林治疗绝经后无症状子宫内膜增厚患者的效果及对性激素结合球蛋白、雌激素的影响

Efficacy of LNG-IUS combined with goserelin in the treatment of postmenopausal patients with asymptomatic endometrial thickening and its effect on sex hormone-binding globulin and estrogen

目的:探讨左炔诺孕酮宫内缓释系统(Levonorgestrel intrauterine sustained release system,LNG-IUS)联合戈舍瑞林治疗绝经后无症状子宫内膜增厚患者的效果及对性激素结合球蛋白、雌激素的影响。方法:选取2021年1月至2023年1月期间我科收治的106例绝经后无症状子宫内膜增厚患者作为研究对象,随机分为观察组和对照组,各53例。对照组脐下皮下注射戈舍瑞林治疗,观察组在对照组基础上联合LNG-IUS治疗,对比两组患者临床疗效、子宫内膜厚度、血清性激素结合球蛋白水平、雌激素水平及不良反应。结果:治疗后,观察组总有效率明显高于对照组(P>0.05)。治疗后1 m,两组患者子宫内膜厚度、血清性激素结合球蛋白水平均无明显差异(P>0.05)。治疗后3 m及6 m,两组患者子宫内膜厚度均明显降低,且观察组更低(P<0.05);两组患者血清性激素结合球蛋白水平均明显降低,且观察组更低(P<0.05)。治疗后6 m,两组患者的血清促黄体生成素(Luteinizing hormone,LH)、促卵泡生成素(Follicle-stimulating hormone,FSH)和雌二醇(Estradiol,E2)水平均明显降低,且观察组更低(P<0.05)。两组不良反应发生率无明显差异(P>0.05)。结论:LNG-IUS联合戈舍瑞林对绝经后无症状子宫内膜增厚患者治疗效果显著,能够降低子宫内膜厚度、性激素结合球蛋白和雌激素水平。

Objective:To investigate the efficacy of levonorgestrel intrauterine sustained release system(LNG-IUS)combined with goserelin in the treatment of postmenopausal patients with asymptomatic endometrial thickening and its effect on sex hormone-binding globulin and estrogen.Methods:A total of 106 patients with postmenopausal asymptomatic endometrial thickening in our department from January 2021 to January 2023 were selected as the study objects,and 53 patients in the control group were given gosereilin treatment,while 53 patients in the observation group were given combined LNG-IUS treatment.Clinical efficacy,endometrial thickness,Serum sex hormone binding globulin levels,estrogen levels and adverse reactions.Results:After treatment,the total effective rate of observation group was higher than that of control group.One month after treatment,there was no difference in endometrial thickness between the two groups compared with before treatment(P>0.05),and at 3 and 6 months after treatment,the endometrial thickness of the two groups decreased(P<0.05),and the observation group was lower(P<0.05).One month after treatment,serum levels of sex hormone-binding globulin were not different between the two groups compared with before treatment(P>0.05)and decreased at 3 and 6 months after treatment(P<0.05),and the observation group was lower(P<0.05).At 6 months after treatment,serum levels of luteinizing hormone(LH),follicle-stimulating hormone(FSH)and estradiol(E2)were decreased in both groups(P<0.05),and were lower in the observation group(P<0.05).The incidence of adverse reactions was similar between the two groups(P>0.05).Conclusion:LNG-IUS combined with goserelin can significantly reduce endometrial thickness,sex hormone binding globulin and estrogen levels in postmenopausal patients with asymptomatic endometrial thickening.