LRH-A对正常育龄妇女溶黄体抗生育作用的临床观察——附88例分析

88例17～42岁,月经规则的健康育龄妇女,在黄体期中期(+5～+8天)时,使用国产促黄体生成激素释放激素(LRH)的激动性类似物D-丙~6,去甘酰胺~(10)]-LRH乙基酰胺(简称LRH-A)以滴鼻法和肌注法连续使用1～5个月经周期时,发现:12例使用LRH-A1000μg/日滴鼻连续4天法的妇女,其溶黄体成功率为75%;18例使用LRH-A 200μg一次肌注组的溶黄体成功率为72.2%;34例使用LRH-A 200μg每隔6小时肌注一次共2次组的溶黄体成功率为94.1%;24例使用LRH-A 200μg/日肌注连续3天法组的溶黄体成功率为96%。其中有1例于肌注LRH-A 200μg后,发生头昏、心慌、呕噁现象,余无明显毒副反应,全部受试者于停药后第一个月即恢复正常的月经周期和生育能力。结果初步表明:LRH-A具有较好的溶黄体效果,且有用药次数少、副作用小和可逆性好等优点,故值得临床进一步研究。

CLINICAL OBSERVATIONS ON LRH-A USED FOR CONTRACEPTION BY LUTEOLYSIS IN NORMAL WOMEN—ANALYSIS OF 88 CASES

88 healthy female volunteers, aged 17～42 yrs., with regular menstrual cycles entered into the trial with a new superactive stimulatory analog of the LRH-A,i.e. (D-Ala~6-EA~(10))-LRH for contraception by luteolysis. The LRH-A was administered intranasally or intramuscularly from days 6～8 after the LH peak / BBT rise for 1～5 successive cycles. Group 1, 12 women, were given LRH-A 1000 μg intranasally q.d. for 4 days; Group 2, 18 women, were given a single dose of 200μg LRH-A I.M. ; Group 3, 34 women, were given 200μg I.M.B.i.d. for one day; Group 4, 24 women, were given 200μg I.M.q.d. for 3 days. During the treatment cycles, no additional contraceptive was used. Luteolysis was defined as a reduction in plasma progesterone and estradiol levels and shortening of the luteal phase associated with an infertile cycle. Luteolysis occured in 9/12 cycles (Group 1), no shortening of luteal phase in 3 cycles; 13/18 cycles (Group 2), no shortening of luteal phase in 5 cycles; 32/34 cycles, (Group 3), no decline of progesterone in 2 cycles; 115/120 cycles (Group 4), 5 pregnancies occured. The results showed that treatment with LRH-A seemed to be more effcient when applied I.M. for twice a day or q.d. for 3～4 successive days as compared with a single dose. No severe side-effect was observed during treatment and apparently normal cycles occured immediately after the withdrawal of treatment. The above data indicatc that an adequate dose of LRH-A can provide a fairly good effect of luteolysis in women at the midluteal phase. However, more extensive study is required before a long term application of LRH-A for contraception by luteolysis can be practical.