穆菁

[摘要]目的 探讨左炔诺孕酮宫内缓释系统（LNG-IUS）应用于子宫内膜异位症（EMs）术后患者取得的疗效。方法 本研究采用回顾性分析的方法，选取2015年 1月～2016年1月于九江市妇幼保健院确诊EMs且行腹腔镜下保守性手术治疗的患者72例，按入院时间分为两组：A组36例给予LNG-IUS治疗；B组36例接受孕三烯酮口服治疗。随诊6个月，观察比较患者治疗前后血清超敏C反应蛋白（hs-CRP）和血管内皮生长因子（VEGF）的变化水平。结果 A组治疗后血清hs-CRP为（3.7±1.0）mg/L，B组治疗后血清hs-CRP为（7.2±1.5）mg/L，均较治疗前明显下降，差异有统计学意义（P<0.05），且A组相较于B组血清hs-CRP下降明显，差异有统计学意义（P<0.05）。A组VEGF为（100.2±14.9）pg/ml，B组VEGF为（148.5±17.5）pg/ml，均较治疗前明显下降，且A组相对B组下降明显，差异有统计学意义（P<0.05）。结论 LNG-IUS在EMs术后患者中的应用能够有效降低炎症因子和VEGF水平，且相较于常规用药孕三烯酮疗效更明显。

[关键词]子宫内膜异位症；左炔诺孕酮宫内缓释系统；超敏C反应蛋白；血管内皮生长因子

[中图分类号] R711.71 [文献标识码] A [文章编号] 1674-4721（2016）11（c）-0126-03

[Abstract]Objective To explore the application effect of the levonorgestrel releasing intrauterine system （LNG-IUS） on postoperative endometriosis （EMs） patients.Methods A retrospective study was made of the 72 cases of patients who were diagnosed as having endometriosis and underwent laparoscopic conservative surgery from January 2015 to January 2016.They were divided into two groups according to admission time：36 cases were treated with LNG-IUS as group A，and the other 36 cases were treated with gestrinoneas as group B.Follow-up of 6 months，before and after treatment the changes of serum high sensitive C reactive protein （hs-CRP） and vascular endothelial growth factor （VEGF） were compared.Results The hs-CRP of group A after treatment was（3.7±1.0） mg/L，the group B was （7.2±1.5）mg/L，the difference was siginificant （P<0.05）；the VEGF of group A was （100.20±14.9） pg/ml，the group B was （148.5±17.5）pg/ml，both decreased significantly compared with before treatment，and compared with group B，the group A was decreased significantly，and the differences were significant（P<0.05）.Conclusion LNG-IUS can effectively reduce the levels of inflammatory factors and vascular endothelial growth factor in patients with endometriosis，and has achieved good therapeutic effect，which has the prospect of research and development.

[Key words]Endometriosis；Levonorgestrel intrauterine system；High sensitivity C reactive protein；Vascular endothelial growth factor

子宮内膜异位症（EMs）[1]在育龄女性中有很高的发病率，且近年来发病人数一直呈上升趋势，其常引发盆腔疼痛和月经失调等并发疾病，对广大女性的生活和健康造成了严重损害，引起了社会性的关注。目前临床上治疗EMs症常采用保守治疗和手术治疗两种方法，最常用的保守性治疗难以达到理想的疗效，而手术治疗常常由于其残留的病灶、较高的手术风险和术后并发症的发生给医生和患者造成困扰[2]。有文献[3]指出，运用LNG-IUS对EMs术后的患者进行治疗，能取得显著的疗效。为了进一步探讨分析该系统治疗EMs的疗效，获得今后在临床运用上的指导意义，本研究以在我院确诊为EMs并接受治疗的患者作为研究对象，运用左炔诺孕酮宫内缓释系统（LNG-IUS）治疗，观察并比较相关研究指标，对其疗效进行分析探讨，现报道如下。……