摘要
目的探讨促性腺激素释放激素激动剂(GnRHa)在治疗子宫内膜异位症(内异症)、子宫腺肌病和子宫肌瘤中的作用以及延长用药间隔对疗效的影响。方法内异症、子宫腺肌病和子宫肌瘤患者共70例,随机分为两组即延长用药间隔组(E组,30例)与常规用药组(C组,40例),分别用曲普瑞林3·75mg肌内注射4次(间隔6周)或6次(间隔4周),疗程均为24周,比较用药前后症状、子宫体积和病灶体积、血清生殖激素水平变化。结果E、C两组中内异症和子宫腺肌病患者的痛经缓解率均为100%;药物治疗结束时子宫体积平均缩小35%和37%,治疗前后比较,差异有统计学意义(P<0·05)。两组患者药物治疗前后血清卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇水平,E组从用药前的(6·7±1·4)U/L、(4·713±1·048)U/L、(209±29)pmol/L,下降到第1次用药后6周的(2·1±0·5)U/L、(0·496±0·212)U/L、(95±18)pmol/L,分别与用药前比较,差异均有统计学意义(P<0·05);用药前及第1次用药后12、24、28周,E、C两组分别比较,差异均无统计学意义(P>0·05)。结论GnRHa通过降低血清FSH、LH和雌二醇水平而缓解痛经、缩小病灶;大多数患者用药间隔延长至6周对疗效无影响,并且可降低医疗费用,可在有血清生殖激素监测条件下推荐应用。
Objective To study the role of triptorelin in the treatment of patients with endometriosis, adenomyoma and fibromyoma and the effect of an extended-interval dosing regimen. Methods Seventy patients suffering from endometriosis, adenomyoma and fibromyoma were divided into two groups： extended-interval dosing （group E） and conventional dosing （group C）. There were treated with injection of triptorelin 3. 75 mg intramuscularly either every 6 weeks of totally four dose regimen （ group E） or every 4 weeks of six dose regimen （ group C）. Comparison was made in improvement of symptoms, size of uterus and volume of tumor, as well as in serum levels of 17β-estradiol, luteinizing hormone, and follicle-stimulating hormone. Results In each group, symptoms and tumor growth significantly improved after treatment （P 〈 0. 05）. For the patients of both groups E and C, the levels of gonadotropins and gonadal steroids were obviously reduced throughout the treatment period and up to 8 - 10 weeks after the injection of the last dose （P〈0.05）. The hormonal profile of group E was similar to group C （P 〉 0.05）. Conclusions Gonadotropin-releasing hormone agonist is efficacious in the treatment of endometriosis and adenomyoma through reducing the serum levels of follicle-stimulating hormone, luteinizing hormone and 17β-estradiol. The curative effect is satisfactory in most patients receiving an extended interval dosing regimen. To reduce the cost of treatment, the extended-interval dosing regimen of triptorelin should be adopted in well-equipped hospitals.
出处
《中华妇产科杂志》
CAS
CSCD
北大核心
2006年第10期656-659,共4页
Chinese Journal of Obstetrics and Gynecology
