Effect and safety of etonogestrel implant and LNG-IUS in treating adenomyosis
10.3760/cma.j.cn101721-20241206-00418
- VernacularTitle:依托孕烯植入剂与LNG-IUS治疗子宫腺肌病患者的效果比较
- Author:
Chengli WU
1
;
Chunyan HU
1
;
Weiqiang WANG
1
;
Liang JIA
1
Author Information
1. 西北妇女儿童医院妇二科，西安 710061
- Publication Type:Journal Article
- Keywords:
Adenomyosis;
Etonogestrel implant;
Levonorgestrel-releasing intrauterine system
- From:
Clinical Medicine of China
2025;41(4):241-247
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect and safety of etonogestrel implant and levonorgestrel-releasing intrauterine system (LNG-IUS) in the treatment of adenomyosis.Methods:Eighty patients with adenomyosis in Northwest Women's and Children's Hospital were selected from September 2021 to September 2023. According to the random number table method, they were divided into observation group and control group, with 45 cases in each group. The patients in observation group were treated with etonogestrel implant, while the patients in control group were given LNG-IUS. The uterine conditions, visual analogue scale (VAS) score, menstrual pattern, sex hormones [estradiol, luteinizing hormone (LH) and follicle stimulating hormone (FSH)] and laboratory indicators [hemoglobin, serum ferritin (SF) and carbohydrate antigen 125] before treatment and after 12 months of treatment and incidence of adverse reactions were compared between the two groups of patients. Measurement data were expressed as xˉ±s. Repeated measures analysis of variance was used for comparison between the two groups at multiple time points. LSD-t test was used for pairwise comparison. Two independent sample t test was used for comparison between the two groups. Paired t test was used for comparison before and after treatment. Enumeration data were expressed as n (%), and χ2 test was used for comparison between groups. Results:After 12 months of treatment, the uterine volume and endometrial thickness in observation group and control group were reduced compared to before treatment [observation group: (122.72±13.52) cm 3 vs. (202.72±20.75) cm 3, (6.83±1.35) mm vs. (9.84±1.76) mm, t=21.67,9.10, respectively, both P<0.001; control group: (134.82±17.64) cm 3 vs. (203.46±20.03) cm 3, (7.52±1.52) mm vs. (9.79±1.82) mm, t=17.25,6.42, respectively, both P<0.001], and the indicators in observation group were lower than those in control group ( t=3.65, 2.28, P<0.001, P=0.025, respectively). The levels of estradiol, LH and FSH were lower than those before treatment[observation group: (1.40±0.30) nmol/L vs. (2.42±0.41) nmol/L, (10.12±1.14) U/L vs. (12.84±2.63) U/L, (5.32±0.87) U/L vs. (9.34±1.35) U/L, t=13.47,6.36,10.03, respectively, all P<0.001; control group: (1.68±0.33) nmol/L vs. (2.40±0.48) nmol/L, (11.41±1.53) U/L vs. (12.96±2.25) U/L, (7.03±1.04) U/L vs. (9.53±1.31) U/L, t=8.29,3.82,16.79, respectively, all P<0.001], and the observation group had lower levels than the control group( t=4.21,4.54,8.46, respectively, all P<0.001). Hemoglobin and SF levels were higher than those before treatment, and the levels in observation group were higher than those in control group [observation group: (116.46±3.07) mg/L vs. (109.46±3.64) mg/L, (117.33±16.46) μg/L vs. (53.82±7.52) μg/L, t=9.86,18.95, respectively, both P<0.001; control group: (114.63±3.48) mg/L vs. (110.63±3.48) mg/L, (95.34±12.63) μg/L vs. (52.58±8.21) μg/L, t=5.45,23.61, respectively, both P<0.001], and the levels in observation group were higher than those in control group( t=2.64,7.11, P=0.010, P<0.001, respectively). The level of carbohydrate antigen 125 was lower than that before treatment, [observation group:(40.31±3.10) kU/L vs.(68.31±4.75) kU/L, t=33.12, P<0.001;control group:(57.45±4.27) kU/L vs.(67.64±4.83) kU/L, t=10.60, P<0.001], and the level in observation group was lower than that in control group ( t=21.79, P<0.001). At 3, 6 and 12 months after treatment, the VAS score in both group decreased gradually, and the scores in observation group were lower than those in control group [(4.35±0.88) points vs. (4.71±0.75) points, (3.21±0.73) points vs. (3.63±0.82) points, (2.64±0.51) points vs. (3.16±0.64) points, all P<0.05]. Before treatment, there was no statistically significant difference in menstrual patterns between the two groups of patients ( P>0.05). After 12 months of treatment, the proportion of normal menstrual patterns in the implant group was higher than that in the sustained-release group [68.9% (31/45) vs. 46.7% (21/45), χ2=4.56, P=0.033], while the proportion of frequent bleeding was lower than that in the sustained-release group [6.7% (3/45) vs. 22.2% (10/45), χ2=4.41, P=0.036]. There was no statistical significant difference in the incidence of adverse reactions between the two groups during treatment [8.9% (4/45) vs. 11.1% (5/45), χ2=0.00, P=1.000]. Conclusion:Compared with LNG-IUS, etonogestrel can more effectively improve the uterine conditions, relieve the dysmenorrhea symptoms, and improve the blood related indicators, and with high safety.
