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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

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【作者】 耿力顾方颖张丽珠

【Author】 Geng Li; Gu Fang-ying;Zhang Li-zhu.(The Third Hospital, Beijing Medical University,100083)

【机构】 北京医科大学第三临床医学院妇产科

【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。

【Abstract】 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 E2 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.

【基金】 国家教委博士点基金
  • 【文献出处】 中华妇产科杂志 ,Chinese Journal of Obstetrics And Gynecology , 编辑部邮箱 ,1994年10期
  • 【分类号】R711.710.5
  • 【被引频次】12
  • 【下载频次】68
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