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促性腺激素释放激素激动剂治疗不孕症合并子宫腺肌病

Gonadotrapin-releasing hormone agonist for the treatment of infertility complicated with adenomyosis

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【作者】 康佳丽夏薇何谦谊刘丽芳

【Author】 KANG Jiali,XIA Wei,HE Qianyi,et al (Guangzhou the First Municipal People’s Hospital,Guangzhou 510180,China)

【机构】 广州市第一人民医院妇产科广州市第一人民医院实验室广州市第一人民医院功能检查室 510180510180

【摘要】 目的 探讨促性腺激素释放激素激动剂(GnRH-α)对不孕症合并子宫腺肌病的疗效。方法 对12例不孕症合并子宫腺肌病行GnRH-a治疗,每月肌注抑那通3.75mg,连用6个月,同时加用利维爱作“反向添加治疗法”;停用GnRH-a后,部分病例应用促排卵和官腔内受精(IUI)。治疗前、后分别进行B超、核磁共振(MRI)检查,血清CA125、生殖激素(FSH、LH、E2)及骨密度(BMD)测定。结果 治疗后痛经等症状缓解,B超和MRI提示子宫腺肌病病灶基本消退,子宫大小恢复正常占83.33%(10/12),血CA125、FSH、LH、E2水平显著降低(P<0.01),腰椎BMD无明显变化(P>0.05),妊娠率达75.0%。结论 CnRH-α是治疗不孕症合并子宫腺肌病的一种有效方法,辅助诱导排卵和IUI,妊娠率进一步提高;应用GnRH-α时,可加用适量的激素补充疗法。

【Abstract】 Objective To study the effect of gonadotropin-releasing hormone agonist (GnRH-a) on infertility complicated with adenomyosis. Methods GnRH-a and sex-steroid add-back therapy were used for twelve patients with infertility complicated with adenomyosis with a dosage of 3.75mg/m for6 months.After withdrawing the GnRH-a,assisted reproductive technology (ART) was used in some of them.Examinations for B-ultra sonography (B-us),MRI,BMD,blood CA125 and sexual hormone were done before and after the therapy. Results After the treatment,the symptom of dysmenorrhea was relieved. B-us and MRI showed focus of adenomyosis disappeared and the volume and size of uteri recovered in 83.33% .The levels of blood CA125 ,FSH,LH,EI decreased significantly ( P < 0.01 ). Lumber bone marrow density (L-BMD) had no significant changes (P>0.05) .The pregnant rate was 75.0%. Conduaons GnRH-a seams effective for the treatment of infertility with adenomyosis. The pregnant rate can be improved significantly with ART. HRT is considered necessary when using GnRH-a.

  • 【文献出处】 中国妇产科临床 ,Chinese Journal of Clinical Obstetric and Gynecology , 编辑部邮箱 ,2000年03期
  • 【分类号】R711.6
  • 【被引频次】1
  • 【下载频次】104
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