Curative Efficacy of Levonorgestrel Sustained Release System Combined with Triptorelin in Treatment of Adenomyosis of the Uterus and its Effect on Serum CA125 CA199 and HE4
FENG Huaping, ZHAO Shaojie, TANG Yan
Wuxi Maternal and Child Health Care Hospital, Jiangsu Wuxi 214000, China
Abstract:Objective: To investigate the efficacy of levonorgestrel sustained-release system combined with triptorelin in the treatment of adenomyosis and its effects on serum carbohydrate antigen 125 (CA125), carbohydrate antigen 199 (CA199) and human epididymal protein 4 (HE4). Methods: 88 patients with adenomyosis in our hospital were selected as the study subjects from April 2015 to April 2017, the randomized table method was used to divide the treatment group into the observation group (n=40) and the control group (n=48). The control group was treated with levonorgestrel sustained release system, and the observation group was treated with levonorgestrel sustained release system combined with triptorelin. The therapeutic effect and serum CA125, CA199 and HE4 levels, uterine volume, dysmenorrhea score, menstrual volume score and adverse reactions were compared between the two groups after treatment. Results: After treatment, the rate of annulus removal and irregular vaginal bleeding in the observation group were lower than those in the control group (P<0.05), and the relief of dysmenorrhea and the improvement of menstruation were higher than those in the control group (P<0.05). There was no significant difference in serum CA125, CA199 and HE4 levels between the two groups before treatment. After treatment, serum CA125, CA199 and HE4 levels of both groups decreased significantly, and serum CA125, CA199 and HE4 levels of the observation group were significantly lower than those of the control group (P<0.05). There was no significant difference in uterine volume, dysmenorrhea score and menstrual volume score between the two groups before treatment. After treatment, the uterine volume, dysmenorrhea score and menses score of the two groups decreased significantly, and the uterine volume, dysmenorrhea score and menses score of the observation group were significantly lower than those of the control group (P<0.05). The total incidence of adverse reactions in the observation group was 10.00%, significantly lower than the control group's 35.42% (P<0.05). Conclusion: In patients with adenomyosis, the use of levonorgestrel sustained release system combined with triptorelin has a significant effect, which can effectively improve the serum CA125, CA199 and HE4 levels of patients, and is worthy of promotion and application.
冯华萍, 赵绍杰, 唐艳. 左炔诺孕酮缓释系统联合达菲林治疗子宫腺肌症的疗效及对血清CA125 CA199 HE4的影响[J]. 河北医学, 2019, 25(1): 1-4.
FENG Huaping, ZHAO Shaojie, TANG Yan. Curative Efficacy of Levonorgestrel Sustained Release System Combined with Triptorelin in Treatment of Adenomyosis of the Uterus and its Effect on Serum CA125 CA199 and HE4. HeBei Med, 2019, 25(1): 1-4.
[1] 董秀凤,郭欣.促性腺激素释放激素激动剂联合放置左炔诺孕酮宫内缓释系统治疗子宫腺肌病的效果[J].广东医学,2017,38(13):2069~2071. [2] Korzekwa A J, Socha B M, et al. Estradiol reduces connexin43 gap junctions in the uterus during adenomyosis in cows[J]. Polish Journal of Veterinary Sciences, 2016, 19(3):609~617. [3] 李雷,冷金花,张俊吉,等.左炔诺孕酮宫内缓释系统放置时机对腺肌病治疗效果的前瞻性队列研究[J].中华医学杂志,2016,96(30):2415~2420. [4] Gordts S, Grimbizis G, Campo R. Symptoms and classification of uterine adenomyosis, including the place of hysteroscopy in diagnosis[J]. Fertility & Sterility, 2018, 109(3):380~388. [5] Yavuzcan A, Bastan M, et al. The effect of adenomyosis on the outcomes of laparoscopic hysterectomy[J].Turk Ger Gynecol Assoc, 2016, 17(3):150~154. [6] 李宝萍.醋酸亮丙瑞林联合腹腔镜切除病灶治疗子宫腺肌症的疗效及不良反应[J].实用医学杂志,2016,32(3):502~503. [7] Yamanaka A, Kimura F, Yoshida T, et al. Dysfunctional coagulation and fibrinolysis systems due to adenomyosis is a possible cause of thrombosis and menorrhagia[J]. European Journal of Obstetrics & Gynecology & Reproductive Biology, 2016, 204:99~103. [8] Ferrari F, Arrigoni F, Miccoli A, et al. Effectiveness of magnetic resonance-guided focused ultrasound surgery (MRgFUS) in the uterine adenomyosis treatment: technical approach and MRI evaluation[J]. Radiologia Medica, 2016, 121(2):153~161.