屈螺酮炔雌醇片联合促性腺激素释放激素激动剂治疗子宫肌腺症的临床研究  

Clinical trial of drospirenone and ethinylestradiol tablets and gonadotropin-releasing hormone agonistin in the treatment of patients with uterine muscular glands

作　　者：岑福柱[1] 谭广萍[1] 李晶晶[1] 蒙俊[1] 陈赛琼[1] CEN Fu - zhu TAN Guang - ping LI Jing - jing MENG Jun CHEN Sai - qiong(Department of Obstetrics and Gynecology, Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou 545005, Guangxi Province, Chin)

机构地区：[1]广西医科大学第四附属医院妇产科,广西柳州545005

出　　处：《中国临床药理学杂志》2017年第12期1116-1119,共4页The Chinese Journal of Clinical Pharmacology

基　　金：国家医学教育发展中心医学研究基金资助项目(2010-37-02-036);广西壮族自治区卫生和计划委员会自筹经费科研基金资助项目(E2016-184)

摘　　要：目的观察屈螺酮炔雌醇联合促性腺激素释放激素激动剂(GnRH-a)治疗子宫肌腺症的临床疗效及其对血清卵巢癌抗原125(CA125)及人附睾蛋白4(HE4)水平的影响。方法 96例子宫肌腺症患者随机分为对照组48例与试验组48例。对照组给予左炔诺孕酮宫内节育系统,放置左炔诺孕酮宫内节育系统后,给予屈螺酮炔雌醇片(每片炔雌醇0.03 mg和屈螺酮3 mg),每日1次,口服,连续服用21 d,停药7 d后继续口服,按此法服药连续3个月。试验组于治疗前3个月给予GnRH-a 3.75 mg,每4周1次,皮下注射,共3次。比较2组患者的临床疗效,观察治疗前后CA125、HE4、B淋巴细胞瘤-2(Bcl-2)、Bcl-2相关X蛋白(Bax)、半胱氨酸-天冬氨酸特异性蛋白酶-3(caspase-3)水平及药物不良反应发生情况。结果治疗后,对照组临床总有效率为81.25%(39/48例),试验组为95.83%(46/48例),差异有统计学意义(P<0.05)。治疗后,试验组血清CA125、HE4、Bcl-2、子宫体积分别为(27.22±0.35)U·L^(-1),(20.67±0.52)pmol·L^(-1),(3.62±0.43)μg·mL^(-1),(95.11±10.29)cm^2,对照组分别为(41.42±0.43)U·L^(-1),(36.67±0.38)pmol·L^(-1),(4.76±0.52)μg·mL^(-1),(120.02±13.92)cm^2(P<0.05)。治疗后,试验组Bax、caspase-3水平的对照组相比,差异有统计学意义(P<0.05)。试验组的药物不良反应有情绪激动、恶心、月经间期出血,药物不良反应发生率为6.25%(3/48例);对照组的药物不良反应有恶心、月经间期出血、皮疹,药物不良反应发生率为14.58%(7/48例),差异无统计学意义(P>0.05)。结论屈螺酮炔雌醇联合GnRH-a治疗子宫肌腺症患者的临床疗效显著,安全性高。Objective To evaluate the clinical efficacy of drospirenone and ethinylestradiol tablets combined with gonadotropin-releasing hormone agonistin（GnRH-a） in treatment of patients with uterine muscular glands and its effect on serum ovarian cancer antigen（CA125） and human epididymis protein（HE4）. Methods A total of 96 patients with adenomyosis were randomly divided into control group and treatment group,each group 48 cases. Control group was given levonorgestrel intrauterine birth control system, placed levonorgestrel intrauterine system,given drospirenone ethinyl estradiol tablets（ethinyl estradiol0. 03 mg and drospirenone 3 mg）,once a day,orally given for 21 d,and stopped for 7 d,then continue for 3 months after discontinuation of oral,according to this method for 3 consecutive months medication. Treatment group was given GnRH-a 3. 75 mg every 4weeks a time before treatment,subcutaneous injection for 3 times. The clinical effect,cancer antigen-125（CA125）,human epididymis protein 4（HE4）,B lymphocyte tumor-2（Bcl-2）,Bcl-2 relative X protein（Bax）,caspase-3and adverse drug reactions in two groups were observed. Results After treatment,the clinical efficacy in control group was 81. 25%（39/48 cases）,had significant difference with that in treatment group,which was 95. 83%（46/48 cases,P〈0. 05）. The levels of serum CA125,HE4 and Bcl-2 and uterine volume in treatment group were（27. 22 ± 0. 35）U·L^-1,（20. 67 ± 0. 52） pmol·L^-1,（3. 62 ± 0. 43） μg·mL^-1,（95. 11 ± 10. 29） cm^2,had significant difference with those in control group,which were（41. 42 ± 0. 43） U·L^-1,（36. 67 ± 0. 38） pmol·L^-1,（4. 76 ± 0. 52） μg·mL^-1,（120. 02 ± 13. 92） cm^2（P〈0. 05）. The levels of Bax and caspase-3 in treatment group had significant difference with control group（P〈0. 05）. The adverse drug reactions in treatment group were agitation,nausea,intermenstrual bleeding,total incidence rate of adverse drug reactions was 6. 25%（3/48 cases）. The advers

关 键 词：屈螺酮炔雌醇片 子宫肌腺症 卵巢癌抗原 附睾蛋白 

分 类 号：R984[医药卫生—药品]