依托孕烯植入剂对子宫腺肌病患者卵巢储备功能及血清CA125水平的影响

Effects of etonogestrel implant on ovarian reserve function and serum CA125 level in patients with adenomyosis

目的探讨依托孕烯植入剂对子宫腺肌病患者卵巢储备功能及血清癌抗原125(CA125)水平的影响。方法选取2019年9月至2022年9月收治的子宫腺肌病患者66例随机分为2组。对照组32例给予左炔诺孕酮宫内节育系统治疗,研究组34例给予依托孕烯植入剂治疗,比较2组患者治疗前、治疗12个月后月经量、痛经程度[视觉模拟评分法(VAS)]、卵巢储备功能[卵泡刺激素(FSH)、雌二醇(E2)、黄体生成素(LH)]及血清血红蛋白、CA125水平变化情况,并统计2组治疗后不良反应发生情况。结果治疗12个月后,2组患者月经量、痛经VAS评分、子宫体积均较治疗前降低(P<0.05),且研究者患者治疗后月经量少于对照组(P<0.05);治疗12个月后,2组患者血清FSH、E2、LH水平与治疗前比较均无明显变化(P>0.05);治疗12个月后,2组患者血清血红蛋白均较治疗前明显升高,血清CA125水平较治疗前明显降低(P<0.05),且研究组患者血清CA125水平显著低于对照组(P<0.05)。结论采用依托孕烯植入剂对子宫腺肌病患者治疗效果与左炔诺孕酮宫内节育系统相当,在月经量改善及降低血清CA125水平作用等方面依托孕烯植入剂疗效更优,且不会对患者卵巢储备功能造成影响,具有较好的安全性。

Objective To investigate the effects of etonogestrel implant on ovarian reserve function and serum cancer antigen 125(CA125)level in patients with adenomyosis.Methods A total of 66 patients with adenomyosis admitted from September 2019 to September 2022 were recruited.They were randomly assigned into the research group(n=34,etonogestrel implant)and control group(n=32,levonorgestrel intrauterine contraceptive system).The menstrual volume,degree of dysmenorrhea were assessed by the Visual Analog Scale(VAS).The ovarian reserve function(follicle stimulating hormone[FSH],estradiol[E2],luteinizing hormone[LH]),and changes in serum hemoglobin and CA125 levels before and 12 months after treatment were compared between the two groups.Adverse events after treatment in both groups were statistically analyzed.Results After 12 months of treatment,the menstrual volume,VAS score of dysmenorrhea,and uterine volume in both groups decreased compared to those before treatment(P<0.05),and the menstrual volume was significantly less in the research group than that of the control group(P<0.05).After 12 months of treatment,there were no significant differences in the changes of serum FSH,E2,LH levels in the two groups compared to before treatment(P>0.05).After 12 months of treatment,both groups showed a significant increase in serum hemoglobin and significant decrease in serum CA125 level compared to before treatment(P<0.05).Serum CA125 level in the research group was significantly lower than that of control group(P<0.05).Conclusion The therapeutic efficacy of etonogestrel implant on adenomyosis is comparable to that of levonorgestrel intrauterine contraceptive system.Etonogestrel implant offers a better effect on improving menstrual flow and reducing serum CA125 levels without impairing the ovarian reserve function,showing a good safety.