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目的探讨左炔诺孕酮宫内释放系统治疗子宫内膜增生伴多囊卵巢综合征(polycystic ovary syndrome,PCOS)的疗效和安全性。方法选择2015年6个月-2016年6月惠州市中心人民医院收治的30例子宫内膜增生伴PCOS患者为研究对象。给予患者单纯左炔诺孕酮宫内释放系统治疗,并比较分析治疗前和治疗6个月后患者子宫内膜厚度及代谢相关指标变化。结果接受左炔诺孕酮宫内释放系统治疗6个月后,各型子宫内膜增生患者的子宫内膜厚度均显著降低(P<0.001)。总胆固醇和低密度脂蛋白胆固醇水平治疗后显著低于治疗前(P<0.05)。雄激素水平在治疗后显著升高(P<0.05)。结论应用左炔诺孕酮宫内释放系统治疗子宫内膜增生伴PCOS能够显著降低子宫内膜厚度,并改善患者血脂代谢,但存在增加患者高雄激素血症的风险。
Objective To investigate the efficacy and safety of levonorgestrel-releasing intrauterine system in the treatment of endometrial hyperplasia and polycystic ovary syndrome (PCOS). Methods Sixty-six cases of endometrial hyperplasia with PCOS were enrolled in this study from June 2015 to June 2016 in Huizhou Central People’s Hospital. Patients were given levonorgestrel intrauterine release system for treatment, and compared before and 6 months after treatment in patients with endometrial thickness and metabolic changes related indicators. Results After six months’ treatment with levonorgestrel-releasing intrauterine system, the endometrial thickness of all types of endometrial hyperplasia was significantly decreased (P <0.001). Total cholesterol and LDL cholesterol levels were significantly lower after treatment than before treatment (P <0.05). Androgen levels increased significantly after treatment (P <0.05). Conclusion Levonorgestrel-releasing intrauterine delivery system for treatment of endometrial hyperplasia with PCOS can significantly reduce the thickness of endometrium and improve the blood lipid metabolism in patients, but there is an increased risk of hyperandrogenism in patients.