不同剂量长效曲普瑞林对子宫内膜异位症患者术后的疗效  

Application of half-dose depot long-acting triptorelin in postoperative adjuvant therapy for endometriosis

作　　者：刘霞[1] 张红霞[1] 王丽萍[1] 付伟平[1] 

机构地区：[1]浙江省嘉兴市妇幼保健院生殖中心,314051

出　　处：《中华医学杂志》2013年第3期208-211,共4页National Medical Journal of China

基　　金：浙江省医药卫生科技计划（2010KYA177）

摘　　要：目的探讨长效曲普瑞林（3．75mg）剂量减半后治疗子宫内膜异位症（EM）的疗效与不良反应。方法前瞻性分析186例中重度EM患者保守性手术后辅助注射半量或全量曲普瑞林6个月的疗效及不良反应。将治疗对象分为3组，半量组（99例）：每次1．875mg；退缩组（52例）：第1次3．75mg，以后每次1．875mg；全量组（35例）：每次3．75mg；均每隔28d用药1次。结果3组患者在第2次用药后均闭经；半量组、退缩组及全量组每次用药后28d血清雌二醇（E2）水平分别有99％、100％和99．0％处于不刺激异位内膜生长的“阈值窗（110～146pmol／L）”内及以下的有效治疗水平，差异无统计学意义（P〉0．05），其中E2〈37pmol／L占E2〈110pmol／L的比例在第1次半量和全量用药后差异无统计学意义（71％比73％，P〉0．05），在第2～5次用药后半量组（69％）低于退缩组（79％）及全量组（85％），差异有统计学意义（P〈0．01）；3组月经首次恢复时盆腔疼痛缓解率及术后1年复发率比较，差异均无统计学意义（均P〉0．05）；半量组围绝经症状及严重围绝经症状的发生率均低于退缩组及全量组，差异均有统计学意义（均P〈0．01）；半量组6次用药完成率高于退缩组及全量组，因严重围绝经症状6次用药未完成率低于退缩组及全量组，差异均有统计学意义（均P〈0．05）。结论曲普瑞林剂量减半后治疗EM有效，减少围绝经症状的发生，降低治疗费用，增加患者治疗的依从性。Objective To evaluate the efficacy and adverse effects of half-dose depot long-acting triptorelin in the therapy of endometriosis. Methods The efficacy and adverse effects of routine-dose or half- dose triporelin in postoperative endometriosis patients were prospectively observed. A total of 186 postoperative patients with moderate or severe endometriosis received an intramuscular injection of triporelin every 28 days for 6 times. They were randomly divided into 3 groups, i.e. half-dose group （ n = 99） ： 1. 875 mg each time; ＂draw-back＂ group （n = 52） ：3.75 mg first time, then 1. 875 mg each time; and routine-dose group （ n = 35 ） ： 3.75 mg each time. Results Amenorrhea was effectively induced in all patients after the second injection. There was no significant difference in the rate of serum E2 level at Day 28 of every injection below the upper limit of ＂ estrogen threshold （ 110 - 146 pmol/L） ＂ not stimulating ectopic endometrium proliferation among half-dose group, ＂ draw-back＂ group and routine-dose group （99% vs 100% and 99.0% , P 〉 0. 05 ）, the percentage of E2 〈 37 pmol/L in E2 〈 110 pmol/L in half-dose group was significantly lower than that in ＂draw-back＂ and routine-dose groups after 2 -5th injection （69% vs 79% and 85% , P 〈 0.01 ）, but there was no significant difference after first half-dose and routine-dose injection （71% vs 73% , P 〉0.05）. No significant difference existed in the rate of pelvic pain relief during the first returning menstruation and the recurrence rate of endometriosis within 1 year postoperation among three groups （ both P 〉 0. 05 ）. However, the incidences of menopausal syndrome and severe menopausal syndrome in half-dose group were significantly lower than those in ＂draw-back＂ and routine-dose groups （both P 〈 0. 01 ）. And the incompletion rate of six-time drug for severe menopause syndrome was also significantly lower （P 〈 0. 05 ） while the completion rate of six-time drug use in half-dose group w

关 键 词：子宫内膜异位症 促性腺激素释放激素激动剂 曲普瑞林 剂量 

分 类 号：R713[医药卫生—妇产科学]