| 摘要: |
| ［摘要］ 目的 探讨左炔诺孕酮宫内缓释系统（LNG-IUS）与地屈孕酮治疗围绝经期子宫内膜增生不伴非典型增生（EH）患者的临床疗效及安全性。方法 选取2022年6月至2025年6月首都医科大学附属北京天坛医院收治的经病理诊断为EH的患者70例为研究对象，根据患者意愿分为LNG-IUS组（采用LNG-IUS治疗，n=37）和地屈孕酮组（采用地屈孕酮治疗，n=33），两组均治疗6个月，比较两组临床症状改善情况、月经情况、子宫内膜情况、子宫内膜病理逆转率以及不良反应发生情况。结果 治疗前两组月经经期、子宫内膜厚度比较差异无统计学意义（P>0.05），治疗6个月后两组月经经期显著缩短，子宫内膜厚度显著降低，且LNG-IUS组显著低于地屈孕酮组（P<0.05）。LNG-IUS组治疗后临床症状改善率（97.30% vs 93.94%）、子宫内膜病理逆转率（100.00% vs 80.00%）高于地屈孕酮组，不良反应率（5.41% vs 12.12%）低于地屈孕酮组，但差异无统计学意义（P>0.05）。结论 LNG-IUS与地屈孕酮均可有效改善EH患者的月经异常及子宫内膜厚度，两组在子宫内膜病理逆转率、临床症状改善率及不良反应率无显著差异，但LNG-IUS治疗呈现更优趋势。 |
| 关键词: 左炔诺孕酮宫内缓释系统 地屈孕酮 子宫内膜增生 围绝经期 |
| DOI：10.3969/j.issn.1674-3806.2026.06.05 |
| 分类号:R 711.74 |
| 基金项目: |
|
| Observation on the clinical efficacy of levonorgestrel-releasing intrauterine system versus dydrogesterone in treatment of perimenopausal patients with endometrial hyperplasia without atypia |
|
ZHAO Yi, ZHANG Luping, BAI Yuqi, YANG Baojun, FENG Limin.
|
|
Department of Obstetrics and Gynecology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
|
| Abstract: |
| ［Abstract］ Objective To explore the clinical efficacy and safety of levonorgestrel-releasing intrauterine system(LNG-IUS) versus dydrogesterone in treatment of perimenopausal patients with endometrial hyperplasia without atypia(EH). Methods A total of 70 patients who were admitted to Beijing Tiantan Hospital, Capital Medical University between June 2022 and June 2025 and were pathologically diagnosed as EH were recruited as the research subjects. The patients were divided into the LNG-IUS group(receiving LNG-IUS treatment, n=37) and the dydrogesterone group(receiving dydrogesterone treatment, n=33) according to their treatment preferences. Both groups were treated for 6 months. The improvement of clinical symptoms, menstrual characteristics, endometrial thickness, endometrial regression rate and adverse reaction profiles were compared between the two groups. Results Before the treatment, there were no statistically significant differences in the menstrual duration and endometrial thickness between the two groups(P>0.05). After the treatment of 6 months, the menstrual period was significantly shortened and the endometrial thickness was significantly decreased in both groups, and the two indicators in the LNG-IUS group were significantly lower than those in the dydrogesterone group(P<0.05). The improvement rate of clinical symptoms(97.30% vs 93.94%) and endometrial regression rate(100.00% vs 80.00%) after the treatment in the LNG-IUS group were higher than those in the dydrogesterone group, and the incidence of adverse reactions(5.41% vs 12.12%) in the LNG-IUS group was lower than that in the dydrogesterone group, but there were no statistically significant differences between the two groups(P>0.05). Conclusion Both LNG-IUS and dydrogesterone can effectively alleviate menstrual abnormalities and reduce endometrial thickness in patients with EH. There are no statistically significant differences in the endometrial regression rate, improvement rate of clinical symptoms and incidence of adverse reactions between the two groups, but LNG-IUS treatment shows a better trend. |
| Key words: Levonorgestrel-releasing intrauterine system(LNG-IUS) Dydrogesterone Endometrial hyperplasia Perimenopause |
