■我们旨在确定和比较多囊卵巢综合征(PCOS)患者在使用左炔诺孕酮宫内缓释系统(LNG-IUS)治疗时的生殖激素水平和代谢。
■从浙江大学医学院金华医院妇产科招募了64名PCOS患者(A组)和66名接受LNG-IUS受孕的健康女性(B组)。
■我们比较了两组病例的一般特征,包括年龄,体重指数(BMI),收缩压(SAP),舒张压(DAP),腹围(AC)和腰围(WC)。对每位患者进行经阴道超声检查(TVS)以确定卵母细胞数和卵巢体积,在前六个月和六个月的左颈总动脉的心电图图像上测量颈总动脉的内中膜厚度(IMT),12个月和24个月后患者插入LNG-IUS。激素水平(促卵泡激素,黄体生成素,血清雌二醇和总睾酮),血清胰岛素,性激素结合球蛋白(SHBG),总胆固醇(TC),高密度脂蛋白(HDL),和甘油三酯(TG),在六个月前进行了评估,在患者12个月和24个月后插入LNG-IUS。比较PCOS组非HA(高雄激素血症)组和HA组的睾酮(T)水平与基线水平。我们还比较了PCOS组中无胰岛素抵抗的病例与基线。
■在插入LNG-IUS之前,PCOS组的总睾酮水平显著升高(p<0.05),较低的HDL水平(p<0.05),卵巢体积大于对照组(p<0.05)。与基线值相比,插入LNG-IUS后6个月空腹血糖显著升高(p<0.05).平均卵巢体积显著小于LNG-IUS插入前的体积(p<0.05);当与PCOS组的基线评估相比时,LDL和TC显著降低。在24个月的随访期内,其余变量没有显着差异。当与LNG-IUS插入之前的时期相比时,对照组没有显示出任何显著的变化。在24个月的随访后比较各组,WC,AC,FSH,LH,T,SHBG,HDL,FINs,两组FAI和卵巢体积比较差异有统计学意义(p<0.05)。
■LNG-IUS是一种有效且安全的非手术装置,使用该系统24个月后,PCOS女性和健康对照女性的临床和代谢变量没有显著变化。
UNASSIGNED: We aimed to determine and compare the reproductive hormone level and metabolic of patients with polycystic ovary syndrome (PCOS) when treated with a levonorgestrel-releasing intrauterine system (LNG-IUS).
UNASSIGNED: Sixty-four women with PCOS (Group A) and sixty-six healthy women inserted with a LNG-IUS for conception (Group B) were recruited from the Department of Obstetrics and Gynecology in Jinhua Hospital Zhejiang University School of Medicine.
UNASSIGNED: We compared the general characteristics of the cases between the two groups, including age, body mass index (BMI), systolic arterial pressure (SAP), diastolic arterial pressure (DAP), abdominal circumference (AC) and waist circumference (WC). Each patient was evaluated by transvaginal ultrasonography (TVS) to determine the number of oocytes and ovarian volume, and the intima-media thickness (IMT) of the common carotid artery was measured on an ECG image from the left common carotid artery before and six months, 12 months and 24 months after patients were inserted with the LNG-IUS. Hormone levels (follicle stimulating hormone, luteinizing hormone, serum estradiol and total testosterone), serum insulin, sex hormone binding globulin (SHBG), total cholesterol (TC), high density lipoprotein (HDL), and triglyceride (TG), were evaluated before and six months, 12 months and 24 months after patients were inserted with an LNG-IUS. The levels of testosterone (T) in the non-HA (hyperandrogenemia) group and HA group in PCOS group were compared with the baseline. We also compared cases without insulin resistance in the PCOS group with their baseline.
UNASSIGNED: Prior to LNG-IUS insertion, the PCOS group had significantly higher total testosterone levels (p < 0.05), lower HDL levels (p < 0.05), and a greater ovarian volume (p < 0.05) than the control group. Compared to baseline values, there was a significant increase in fasting glycemia at six months after LNG-IUS insertion (p < 0.05). Mean ovarian volume was significantly smaller than the volume prior to LNG-IUS insertion (p < 0.05); LDL and TC were significantly reduced when compared to baseline evaluation in the PCOS group. The remaining variables did not differ significantly during the 24 months follow-up period. The control group did not show any significant changes when compared to the period before LNG-IUS insertion. When the groups were compared after the 24-month follow-up, WC, AC, FSH, LH, T, SHBG, HDL, FINs, FAI and ovarian volume were significantly different when compared between the two groups (p < 0.05) .
UNASSIGNED: The LNG-IUS is an effective and safe non-surgical device and the use of this system for 24 months did not result in significant changes in the clinical and metabolic variables in women with PCOS and healthy control females.