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目的探讨左炔诺孕酮宫内缓释系统(LNG-IUS)对增生过长子宫内膜形态计量学的影响。方法用计算机图像分析系统测定增生过长子宫内膜LNG-IUS治疗前及治疗3个月后子宫内膜形态计量学参数的改变,并与子宫内膜增生过长炔诺酮治疗后的子宫内膜计量学参数相比较。结果LNG-IUS治疗前子宫内膜腺体数目、腺细胞核分裂数、间质细胞核分裂数、腺腔横切直径及腺上皮细胞高度分别为9.1±1.0、1.5±0.5、1.2±0.7、(90±14)μm、(20.4±12.1)μm,LNG-IUS置入子宫腔内3个月后,子宫内膜腺体数目、腺细胞核分裂数、间质细胞核分裂数减少、腺腔横切直径及腺上皮细胞高度减小,分别为1.6±0.8、0、0、(25±5)μm、(4.9±1.2)μm,前后比较差异有统计学意义(P均<0.05)。LNG-IUS研究组子宫内膜腺体数目、腺腔横切直径与炔诺酮对照组比较,两组差异有统计学意义(P<0.05)。LNG-IUS研究组腺上皮细胞高度较炔诺酮对照组低,但两者差异无统计学意义(P>0.05);两组中均未见到腺上皮细胞和间质细胞核分裂相。结论形态计量学研究表明ING-IUS有强烈的抗子宫内膜增殖作用,其对子宫内膜增殖抑制程度显著大于口服炔诺酮治疗。
Objective To investigate the effect of levonorgestrel-releasing intrauterine system (LNG-IUS) on histomorphometry of hypertrophic endometrium. Methods The computer image analysis system was used to measure the change of endometrial morphometry before LNG-IUS hyperplasia endometrium treatment and 3 months after treatment, and with the endometrial hyperplasia prolongation of norethindrone Membrane metrology parameters compared. Results The number of endometrial glands, mitotic glandular cells, mesenchymal cell fission, gland lumen cross-sectional diameter and glandular epithelial cell height before LNG-IUS treatment were 9.1 ± 1.0,1.5 ± 0.5,1.2 ± 0.7, (90 ± 14) μm and (20.4 ± 12.1) μm, respectively. After three months of LNG-IUS implantation into the uterine cavity, the number of endometrial glands, mitotic glandular fission number, mitotic number of mesenchymal cells, The cell height was 1.6 ± 0.8, 0,0, (25 ± 5) μm and (4.9 ± 1.2) μm, respectively. The difference was statistically significant before and after (P <0.05). LNG-IUS study group, the number of endometrial glands, gland lumen cross-sectional diameter and norethindrone control group, the difference between the two groups was statistically significant (P <0.05). The height of glandular epithelial cells in LNG-IUS group was lower than that in norethindrone group, but there was no significant difference between the two groups (P> 0.05). No glandular epithelial cells and mesenchymal mitotic phase were found in LNG-IUS group. Conclusion Morphometric studies show that ING-IUS has a strong anti-proliferative effect on endometrium, and its inhibitory effect on endometrial proliferation is significantly greater than that of oral norethindrone.