【摘要】 目的 :探讨促性腺激素释放激素激动剂 (GnRH a)与炔诺酮联合治疗子宫腺肌病的疗效及安全性。方法 :将 6 0例子宫腺肌病患者随机分为两组 ,每组 30例。A组采用GnRH a加炔诺酮治疗 ;B组单独应用GnRH a。观察治疗前后症状、体征、肝肾功能、血脂代谢、腰椎骨密度 (BMD)变化 ,统计停药后妊娠率。结果 :两组总主观症状评分及子宫体积于治疗后均明显下降 ,两组治疗后肝肾功能、空腹血糖均在正常范围。血甘油三脂 (TG)、载脂蛋白A(ApoA)、血钙、磷、碱性磷酸酶、BMDB组治疗后与治疗前比较及两组间比较差异均有显著性 ,A组发生低雌激素症状较B组明显少。A、B组治疗后妊娠率分别为 4 6 7%、4 1 4 % (P <0 0 5 )。结论 :GnRH a联合炔诺酮可有效治疗子宫腺肌病 ,提高妊娠率 ,并能减轻低雌激素症状 ,降低出血率 ,减缓骨转换。更多还原

【Abstract】 Objective: To study the efficacy and safety of combining gonadotropin-releasing hormone agonist (GnRH-a) with norethindrone in the treatment of adenomyosis. Methods: Sixty women with adenomyosis were randomized into two groups. Group A( n =30) were treated with GnRH-a plus norethindrone and group B( n =30) received only GnRH-a. Symptoms and signs were recorded before and after the treatment. Liver and renal functions, lipid, bone metabolism, and BMD in the lumbar were also examined at the same time. All datas were analyzed using paired and grouped student’s t-tests. Results: Total subjective symptom scores and uterine volume decreased after treatment in two groups. After treatment, liver and renal functions, and fast blood sugar of both groups were all in normal range. Compared with pre-treatment and group A, serum trigyceride (TG), apolipoprotein A (ApoA), serum calcium and phosphorus, and alkaline phosphatase levels, and BMD in group B were significantly lower. There were less low-estrogenic symptoms in group A. Conclusions: GnRH-a combined with norethindrone is an effective therapy in the treatment of adenomyosis. It could also improve the symptom of hypoestrogenemia, decrease hemorrhage rate and bone turn-over, and increase the pregnant rate.更多还原