促性腺激素释放激素激动剂治疗子宫内膜异位症的疗效与安全性

目的 了解促性腺激素释放激素激动剂(GnRH-a)治疗复发的子宫内膜异位症和特殊部位的子宫内膜异位症(如阴道直肠隔或会阴子宫内膜异位症)的疗效与安全性。方法 观察21例子宫内膜异位症患者采用GnRH-a曲普瑞林治疗前后的症状、体征、子宫内膜异位症病灶大小、肝肾功能、血脂的变化以及不良反应。结果 曲普瑞林于治疗4周后总主观症状评分下降了45％,8周后下降70％,12周后下降88％,16周后下降91％;与治疗前比较,子宫内膜异位病灶大小于治疗16周后下降了34％(P<0.01)。肝、肾功能、血脂等生化指标均在正常范围,且治疗前后无明显变化(P>0.05)。潮热、出汗等血管舒缩症状的发生率为40％,不规则阴道出血的发生率为11％。结论 曲普瑞林治疗子宫内膜异位症安全、有效,但由于可发生潮热、出汗、不规则阴道出血等低雌激素症状,疗程不宜超过6个月。

The efficacy and safety of gonadotropin - releasing hormone agonist Diphereline in the treatment of endometriosis

Objective To study the efficacy and safety of Gonadotropin - Releasing Hormone Agonist (CnRH - a) Diphereline in the treatment of endometriosis. Methods Symptoms , signs , endometrial foci and side - effects of 21 cases with endometriosis were recorded before and after treatment with Diphereline, while liver and renal functions, and lipid in serum were also examined at the same time.Results Total subjective symptom scores showed 45% decrease at 4 weeks, 70% at 8 weeks, 88% at 12 weeks, 91% at 16 weeks after treatment (P < 0.01) .Reduction of 34% in endometrial foci were observed at 16 weeks after treatment (P < 0.01) . Liver and renal functions and sera lipid were all in normal range, showing no differences before and after treatment (P > 0.05) . The percentages of hot flash and sweat were 40% , but vaginal bleeding was 11% .Conclusions Diphereline is effective and safe in the treatment of endometriosis. However, the period of treatment is better not more than 6 months because of hypoestrogenemia such as hot flash, sweat and irregular vaginal bleeding, etc.