米非司酮联合左炔诺孕酮宫内缓释系统对子宫肌瘤患者的临床疗效观察

单雪

【摘要】 目的：觀察米非司酮联合左炔诺孕酮宫内缓释系统对子宫肌瘤患者的临床疗效。方法：选取2018年6月-2020年10月本院收治的118例子宫肌瘤患者作为研究对象，应用随机数字表法分为常规组和联合组，每组59例。其中常规组给予左炔诺孕酮宫内缓释系统进行治疗，联合组在常规组基础上口服米非司酮进行治疗。比较两组治疗后的临床疗效和不良反应发生情况，治疗前后的月经量、子宫肌瘤体积、子宫体积、性激素水平及细胞因子水平。结果：常规组总有效率为86.44%，低于联合组的98.31%（P<0.05）。两组治疗后月经量、子宫肌瘤体积和子宫体积，E2、LH、FSH、PRL水平，MCP-1、

IGF-1、CA125、VEGF水平较治疗前均明显降低，且联合组均明显低于常规组，差异均有统计学意义（P<0.05）。联合组不良反应发生率为5.08%，与常规组的3.39%比较，差异无统计学意义（字2=0.209，P=0.648）。结论：应用米非司酮联合左炔诺孕酮宫内缓释系统治疗子宫肌瘤患者效果明显，显著降低月经量、子宫肌瘤体积和子宫体积、性激素水平、细胞因子水平，且安全性较高。

【关键词】 米非司酮 左炔诺孕酮宫内缓释系统 子宫肌瘤 单核细胞趋化因子-1 子宫肌瘤体积

Clinical Effect of Mifepristone Combined with Levonorgestrel-releasing Intrauterine System for Patients with Hysteromyoma/SHAN Xue. //Medical Innovation of China， 2021， 18（32）： 0-060

[Abstract] Objective： To observe the clinical effect of Mifepristone combined with Levonorgestrel-releasing intrauterine system for patients with hysteromyoma. Method： A total of 118 patients with hysteromyoma admitted from June 2018 to October 2020 were selected as the study objects and randomly divided into conventional group and combined group， 59 cases in each group. The conventional group was treated with Levonorgestrel-releasing intrauterine system， while the combined group was treated with Mifepristone on the basis of the conventional group. The clinical efficacy and adverse reactions after treatment， including menstrual volume， uterine leiomyoma and uterine volume， sex hormone levels and cytokine levels before and after treatment of two groups were compared. Result： The total effective rate in the routine group was 86.44%， which was lower than 98.31% in the combined group （P<0.05）. After treatment， the menstrual volume， uterine fibroids volume and uterine volume， E2， LH， FSH， PRL levels， MCP-1， IGF-1， CA125 and VEGF levels in two groups were significantly lower than those before treatment， and the combined group were significantly lower than those of the conventional group， the differences were statistically significant （P<0.05）. The incidence of adverse reactions in the combined group was 5.08%， compared with 3.39% in the conventional group， the difference was not statistically significant （字2=0.209， P=0.648）. Conclusion： Mifepristone combined with Levonorgestrel-releasing intrauterine system in the treatment of hysteromyoma has obvious effect， can significantly reduce menstrual volume， uterine leiomyoma volume and uterine volume， sex hormone levels， cytokine levels， and high safety.

[Key words] Mifepristone Levonorgestrel-releasing intrauterine system Hysteromyoma Monocyte chemoattractant factor-1 Uterine leiomyoma volume

First-author’s address： Panjin Central Hospital， Panjin 124200， China

doi：10.3969/j.issn.1674-4985.2021.32.014

子宫肌瘤是由子宫平滑肌细胞增生而形成的一种良性肿瘤，典型的临床症状包括经量增多、经期延长、下腹包块、白带增多等，严重者会导致贫血、急腹症、不孕症，影响患者的生命健康[1]。目前临床上常用药物和手术治疗该病，其中手术治疗适用于无生育需求或高龄患者，药物治疗往往是多数患者的首选。……