促黄体激素释放激素类似物治疗子宫内膜异位症的研究  

Treatment of endometriosis with domestic luteinizing hormone -relasing hormone ana-logue

作　　者：耿力[1] 顾方颖[1] 张丽珠[1] 

机构地区：[1]北京医科大学第三临床医学院妇产科

出　　处：《中华妇产科杂志》1994年第10期592-594,共3页Chinese Journal of Obstetrics and Gynecology

基　　金：国家教委博士点基金

摘　　要：对６０例子宫内膜异位症病人，于早卵泡期给予促黄体激素释放激素类似物（ＬＨＲＨ－Ａ），每日４００μｇ，分两次皮下注射，共６～１０个月。结果：用药６天后促卵泡激素（ＦＳＨ）、促黄体激素（ＬＨ）对ＬＨＲＨ－Ａ失去反应，２周后排卵或（和）黄体功能受抑制，１个月后雌二醇低于卵泡早期水平。子宫内膜萎缩。临床症状和体征及腹腔镜检查所见明显改善。副作用主要是潮热等雌激素水平低下的表现。停药后３４～７２天月经恢复，１３例不孕者８例妊娠。追踪半年至５年，症状或体征重现率３７％。提示：长期大量应用ＬＨＲＨ－Ａ，可抑制卵巢功能，但作用是暂时性、可复性的；副作用小，无肝脏损害及男性化作用。ixty patients with endometriosis,stage Ⅰ～Ⅳ,di-agnosed by laparoscopy or laparotomy,were treatedwith 200 μg of domestic luteinizing hormone-releasinghormone analogue(LHRH-A)subcutaneously twicedaily,starting from the early follicular phase for 6～10months. Serum FSH and LH levels devated at first de-clined significantly thereafter,and remained low afterthe sixth day of treatment.Serum E_2 concentrationswere suppressed below that of the early follicular phaseor to the castrated levels after one month of therapy.Symptoms and signs of endometriosis improved marked-ly during the treatment and patients became anovulatoryand amenorrheic。At thend of treatment.resolution ofendometriotic implants and softening of adhesions wereshown under the second laparoscopy. Endometrial biop-sies revealeed inactive endometrium.After discontinua-tion of the treatment , ovulatory menses returned within34～72 days,more than half of the patients complicatedwith infertility for 2～10 years hacame pregnant within1～8months. The recurrence rate was 37%after 0.5～5year follow-up. Side effects were only related to hy-pooestrogenism. These data indicated that LHRH-Atherapy had the effect of temporary reversible medicalcophorectomy,and was therefore an effective approachfor the treatment of endometriosis.

关 键 词：促黄体激素 释放激素 子宫内膜异位 

分 类 号：R711.710.5[医药卫生—妇产科学]