促黄体激素释放激素类似物与低剂量炔诺酮联合治疗子宫内膜异位症的疗效与安全性  

The Efficacy and Safety of Domestic Luteinizing Hormone-releasing Hormone Analogue and Low-dose Norethindrone“Add-back”Therapy in the Treatment of Endometriosis

作　　者：张绍芬[1] 叶国春[1] 陈行 方芳 张剑峰[1] 朱关珍[1] 

机构地区：[1]上海医科大学妇产科医院妇科,200011

出　　处：《中华妇产科杂志》2000年第8期482-485,共4页Chinese Journal of Obstetrics and Gynecology

基　　金：上海市教育发展基金会资助(基金编号:97-66)

摘　　要：目的　了解国产促黄体激素释放激素类似物 (LHRH a)与低剂量炔诺酮联合治疗子宫内膜异位症 (内异症 )的疗效及安全性。方法　将 77例内异症患者随机分为两组 ,A组 36例 ,采用LHRH a 15 0 μg每日肌内注射 (肌注 ) +炔诺酮 2 .5mg每日口服治疗 ;B组 41例 ,单独应用LHRH a肌注 ,疗程 3～ 6个月。观察治疗前后症状、体征、肝、肾功能、血脂代谢、骨代谢生化指标及右侧胫骨超声速度 (SOS)变化。结果　A组总主观症状评分于治疗 3个月后下降了 82 % ,6个月后下降了 94% ,内异症病灶于 3个月后缩小了 34 % ,6个月后缩小了 6 1% (与治疗前比较 ,P <0 .0 1)。B组总主观症状评分于 3、6个月后分别下降了 77%、90 % ,内异症病灶分别缩小了 37%、38% (P <0 .0 1)。肝、肾功能、空腹血糖均在正常范围。B组血甘油三酯 (TG)、载脂蛋白A(ApoA)、血钙、磷、碱性磷酸酶等于治疗后显著升高。B组TG于治疗 3个月后、ApoA于治疗 6个月后比A组明显升高 (P <0 .0 5 ,P <0 .0 1) ;血钙于治疗 3个月后、血磷于治疗 6个月后、血碱性磷酸酶于治疗 3、6个月后也比A组明显升高 (P <0 .0 5 ,P <0 .0 5 ,P <0 .0 0 1,P <0 .0 1)。SOS在治疗前后及组间均无显著性改变。A组潮热等副反应发生率为 14% ,B组为 41% (P <0 .0 1)。A组与B组阴道?Objective To study the efficacy and safety of combining domestic luteinizing hormone releasing hormone analogue(LHRH a) with low dose norethindrone in the treatment of endometriosis. Methods Seventy seven women with endometriosis were randomized into one of the following two groups. Group A ( n =36) were treated with LHRH a (150 μg/d, i.m.) plus norethindrone (2.5 mg/d, p.o.) and group B ( n =41) received only LHRH a (150 μg/d, i.m.) for 3 to 6 months. Symptoms and signs were recorded before and after the treatment. Liver and renal functions, lipid and bone metabolism and speed of sound (SOS) in the tibia were also examined at the same time. All data were analyzed using paired and grouped Student′s t tests. Results Total subjective symptom scores of group A showed 82% decrease at 3 months and 94% at 6 months of treatment ( P <0.01). Reductions in endometriotic foci were 34% and 61% at 3 and 6 months, respectively ( P <0.01). Of group B, there were 77% and 90% decreases in total subjective symptom scores at 3 and 6 months of treatment ( P <0.01). Reductions of 37% and 38% in endometriotic foci were observed at 3 and 6 months, respectively ( P <0.01). Liver and renal functions and fast blood sugar of both groups were all in normal range. Triglyceride (TG), apolipoproteinA (ApoA), serum calcium, phosphorus and alkaline phosphatase levels of group B increased significantly after treatment. And significant differences between the two groups were observed. There′s no change of SOS in the tibia within or between the two groups before and after treatment. The percentages of hemorrhage in the group A and B were 18% and 38%,respectively. The percentages of hot flush and the other vasomotor symptoms were 14% and 41%, respectively ( P <0.01). Conclusions Domestic LHRH a combined with low dose norethindrone was effective in the treatment of endometriosis. It could also improve the symptom ofhypoestrogenemia, decrease hemorrhage rateand bone turn over.

关 键 词：促性腺素释放激素 子宫内膜异位症 炔诺酮 

分 类 号：R711.71[医药卫生—妇产科学]