促性腺激素释放激动剂联合宫内放置LNG-IUS对EMT患者术后复发、痛经程度及性激素和CA125水平的影响

doi:10.3969/j.issn.1671-7171.2021.02.022

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摘要 【目的】 探讨促性腺激素释放激动剂(GnRH-a)联合宫内放置左炔诺孕酮宫内缓释系统(LNG-IUS)对子宫内膜异位症(EMT)患者术后复发、痛经程度及性激素、糖抗原125(CA125)水平的影响。【方法】 选取在陕西省宝鸡市眉县人民医院拟行腹腔镜手术的EMT患者107例,按照随机数表法分为观察组(n=54)和对照组(n=53)。观察组术后给予GnRH-a 治疗3个周期,并宫内放置LNG-IUS;对照组术后仅给予GnRH-a 治疗3个周期。比较两组患者术前、术后不同时间的痛经程度(VAS评分)、血清CA125、雌二醇(E₂)、卵泡刺激素(FSH)、促黄体生成素(LH),随访24个月,统计患者的复发情况。【结果】 术后3个月、12个月及24个月,观察组患者的VAS评分均显著低于对照组(P<0.05);两组患者手术前后E₂、FSH、LH水平比较差异均无统计学意义(P>0.05);两组患者术前血清CA125水平比较差异无统计学意义(P>0.05);术后12个月,观察组患者的血清CA125水平显著低于对照组(P<0.05)。术后随访24个月,观察组患者复发率为1.87%(1/53),显著低于对照组的12.96%(7/54)(P<0.05),其差异有统计学意义(χ²=4.744,P=0.029)。【结论】 EMT患者术后宫内放置LNG-IUS,可减少复发,降低血清CA125水平,缓解痛经,值得临床推广应用。

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	张娟
	韩小曼
	肖敏素

关键词 ：子宫内膜异位症/治疗, 促性腺素释放激素/激动剂, 性腺甾类激素, 痛经, CA-125抗原/血液

Abstract：【Objective】 To investigate the effects of gonadotropin releasing agonist (GnRH-a) combined with levonorgestrel intrauterine sustained release system (LNG-IUS) on postoperative recurrence, reproductive hormone, dysmenorrhea, and serum glycoprotein 125 (CA125) in patients with endometriosis (EMT) postoperatively. 【Methods】 A total of 107 patients with EMT who underwent laparoscopic resection were enrolled in the study. Patients were randomly divided into the observation group (n=53) and the control group (n=54). The observation group received a gonadotropin-releasing agonist (GnRH-a) for 3 cycles after surgery, and then LNG-IUS was placed in the uterus; while the control group only received GnRH-a for 3 cycles of treatment after operation. The degree of dysmenorrhea (VAS score), serum CA125, Estrogen (E₂), follicle stimulating hormone (FSH) and luteinizing hormone (LH) were compared between the two groups before and after surgery. The incidence of recurrence were followed up for 24 months. 【Results】 The dysmenorrhea degree (VAS) of the observation group was lower than that of the control group at 3 months, 12 months and 24 months after operation (P<0.05). There was no significant difference in the levels of E₂,FSH, and LH between the two groups before and after operation (P>0.05). There was no significant difference in serum CA125 levels between the two groups before surgery (P>0.05);12 months after surgery, the serum CA125 level of the observation group was lower than that of the control group (P<0.05). After 24 months of follow-up, the recurrence rate of the observation group was 1.87% (1/53) , which was lower than that of the control group (12.96%,7/54). The difference was statistically significant (χ2=4.744, P<0.05).【Conclusion】 Intrauterine placement of LNG-IUS after EMT patients plays an important role in preventing recurrence, lowering serum CA125 level, and further alleviating dysmenorrhea.

Key words： Endometriosis/TH Gonadotropin-Releasing Hormone/AG Gonadal Steroid Hormones Dysmenorrhea CA-125 Antigen/BL

收稿日期: 2019-10-18

中图分类号:

R711.71

通讯作者: *E-mail:394362040@qq.com

引用本文:

张娟, 韩小曼, 肖敏素. 促性腺激素释放激动剂联合宫内放置LNG-IUS对EMT患者术后复发、痛经程度及性激素和CA125水平的影响[J]. 医学临床研究, 2021, 38(2): 237-239.
ZHANG Juan, HAN Xiao-man, XIAO Min-su. Effect of GnRH-a Combined with Intrauterine Placement of LNG-IUS on Postoperative Recurrence, Reproductive Hormone, Dysmenorrhea and Serum CA125 in Patients with EMT. JOURNAL OF CLINICAL RESEARCH, 2021, 38(2): 237-239.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2021.02.022 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2021/V38/I2/237