| 米非司酮用于左炔诺孕酮宫内缓释系统治疗子宫腺肌病前预治疗的临床对比研究 |
| 投稿时间：2010-10-19 修订日期：2010-11-03 点此下载全文 |
| 引用本文：徐肖文,朱雪琼,卢晓声,王乐丹,管玉涛,王溢.米非司酮用于左炔诺孕酮宫内缓释系统治疗子宫腺肌病前预治疗的临床对比研究[J].医学研究杂志,2012,41(5):65-69 |
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| 基金项目:2007浙江省计划生育委员会资助项目；2009温州市科技局资助项目（2009S0158） |
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| 中文摘要:目的探讨米非司酮用于左炔诺孕酮宫内缓释系统（LNG-IUS）治疗子宫腺肌病前预治疗的疗效及不良反应。方法选择宫腔深度＞9cm且不愿接受手术治疗的子宫腺肌病患者37例，随机分为米非司酮组24例和GnRH-a组14例，经米非司酮或GnRH-a预治疗直至测量宫腔深度≤9cm时放置 LNG-IUS。在预治疗前及放置LNG-IUS前后检测子宫体积、血红蛋白和CA125值、骨密度值，并进行月经量PBAC和痛经 VAS 评分。结果①米非司酮组预治疗前、后子宫体积为249.27±4261cm3、181.05±26.65cm3，两者比较差异有显著统计意义；②米非司酮组预治疗前、后血红蛋白值为80.50±12.40g/L、10755±6.87g/L，两者比较差异有显著统计学意义；米非司酮组预治疗前、后血清CA125值为83.05±35.76IU/ml、61.27±2503IU/ml，差异有显著统计学意义；③米非司酮组预治疗前痛经VAS评分为6.41±1.56，放置 LNG-IUS后6个月和12个月下降为1.64±1.05和1.36±0.73，差异有显著统计学意义；④米非司酮组预治疗前、后骨密度比较，差异无统计学意义。结论米非司酮可有效缩小子宫腺肌病患者子宫体积，改善临床症状，降低CA125值，可作为子宫腺肌病患者放置ING-IUS治疗前的预治疗，与GnRH-a比较具有口服方便，价格低廉，不影响骨密度，不良反应较小的优势。 |
| 中文关键词:米非司酮 子宫腺肌病 左炔诺孕酮宫内缓释系统 预治疗 |
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| Pretreatment of Mifepristone before Levonorgestrel-releasing Intrauterine System in Treatment of Adenomyosis: a Comparative Clinical Study |
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| Abstract:ObjectiveTo evaluate the efficiency of mifepristone pretreatment before levonorgestrel-releasing intrauterine system (LNG-IUS) in adenomyosis treatment. MethodsTotally 37 adenomyosis patients with over 9cm uterine cavity depth were divided into 2 groups: mifepristone group and GnRH-a group. LNG-IUS were inserted until uterine cavity depth reduced to ≤9cm after mifepristone or GnRH-a pretreatment. We evaluated the uterine volume,the PBAC bleeding scores, visual analogue scale (VAS) scores before and after pretreatment.Hemoglobin, serum CA125 level and bone mineral density(BMD) were tested at the same time. Results①The uterine volume decreased from 249.27±42.61cm3 to 181.05±26.65cm3 after 3 to 9 months mifepristone treatment. ② In mifepristone group, hemoglobin level was significantly increased from 80.50±12.40g/L to 118.64±6.67g/L and serum CA125 level was decreased from 83.05±35.76 IU/ml to 61.27±25.03 IU/ml after pretreatment of mifepristone. ③ The mean VAS score dropped from6.41±1.56 to 1.64±1.05, 1.36±0.73 after LNG-IUS inserted 6,12 months later,which showed statistical significance in comparing to the score before treatment. ④Bone mineral density was on statistically difference before and after mifepristone pretreatment. ConclusionOrally taking mifepristone before LNG-IUS insertion decreased the uterine volume and the menstrual blood loss, relieved clinical symptoms, reduced the level of serum CA125.Compared to GnRH-a pretreatment, mifepristone was more convenient, cheap and produced less side effects especially bone loss. |
| keywords:Mifepristone Adenomyosis Levonorgestrel intrauterine system（LNG-IUS） Pretreatment |
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