Objectives:To study the effect of levonorgestrel intrauterine releasing system on endometrium of patients with anovulatory uterine bleeding.Methods:124 patients with anovulatory uterine bleeding from January 1,2014 to June 1,2015 were randomly selected and divided into observation group and control group,with 62 cases in each group.Control group received oral levonorgestrel treatment and observation group received levonorgestrel intrauterine releasing system for treatment of uterine cavity.Three months menstrual flow,endometrial thickness,hemoglobin level and PBAC score before and after treatment of two groups were detected.Levels of progesterone (P),estrogen (E2),follicle stimulating hormone (FSH),testosterone (T) and luteinizing hormone (LH) and other related hormone levels were observed.Cases of adverse reactions after treatment were recorded.Results:Before treatment,menstrual bleeding volume,hemoglobin level,endometrial thickness and PBAC scores of two groups had no statistically significant difference (P ＞ 0.05).After treatment,the four indexes of two groups were obviously improved (P ＜ 0.05).And menstrual flow,endometrial thickness and PBAC scores of observation group were significantly lower than these of control group.Hemoglobin levels of observation group (125.8 ± 14.2) g/L was higher than that of control group (118.9 ± 13.7) g/L,with statistically significant difference (P ＜ 0.05).Before treatmernt,the related hormone levels of two groups had no statistically significant difference (P ＞ 0.05).After treatment,the related hormone levels of two groups were significantly improved (P ＜ 0.05).And FSH,LH and T levels of observation group and control group had no significant difference (P ＞ 0.05).The difference between observation group and control group in E2 and P levels had statistically significant difference (P ＜ 0.05).There were five cases of adverse reactions in observation group and 13 cases of adverse reactions in control group.The difference in adverse reaction rate of two groups was statistically significant (P ＜ 0.05).Conclusion:Application of levonorgestrel intrauterine releasing system can effectively reduce the thickness of endometrium,influence changes of hormone levels and lower incidence of adverse events,with more security.%目的:观察分析无排卵性子宫出血患者应用左炔诺孕酮宫内缓释系统对子宫内膜的影响.方法:采用抽签法随机选取我院自2014年1月至2015年6月收治的无排卵性子宫出血患者共计124例,并按照随机数表法将其随机分成观察组与对照组各62例.对照组给予口服左炔诺孕酮治疗,观察组则在宫腔中置入左炔诺孕酮宫内缓释系统进行治疗.测定患者治疗前和治疗后3个月的经量、子宫内膜厚度、血红蛋白水平、PBAC评分,同时观察孕激素(P)、雌激素(E2)、卵泡刺激素(FSH)、睾酮(T)以及促黄体生成素(LH)等相关激素水平的变化,统计治疗后不良反应的例数.结果:治疗前两组无排卵性子宫内膜出血患者的月经量、血红蛋白水平、子宫内膜厚度及PBAC评分比较均无统计学差异(P＞0.05).治疗后,两组患者以上四个指标较治疗前均明显改善(P＜0.05).且观察组患者月经量、子宫内膜厚度、和PBAC评分明显低于对照组,观察组血红蛋白水平(125.8±14.2)g/L高于对照组(118.9±13.7)g/L,差异有统计学意义(P＜0.05).治疗前,两组患者的相关激素水平比较无统计学意义(P＞0.05).治疗后,两组患者的相关激素水平较治疗前均明显改善(P＜0.05).且观察组和对照组的FSH、LH及T水平相比无明显差异(P＞0.05),而E2和P水平与对照组相比,差异具有统计学意义(P＜0.05).观察组共发生不良反应5例和对照组13例不良反应相比较,其不良反应率(8.06％)明显低于对照组(20.96％),比较差异有统计学意义(P＜0.05).结论:应用左炔诺孕酮宫内缓释系统能够更有效地降低子宫内膜厚度,影响体内相关激素水平的变化,降低治疗中和治疗后的不良反应发生率,更具安全性.
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