子宫肌瘤动脉栓塞治疗:对卵巢功能的影响及血清性激素的变化

目的:探讨子宫动脉栓塞术(UAE)治疗子宫肌瘤对月经和卵巢功能的影响。方法:66例子宫肌瘤行UAE后随访3～33个月,观察月经变化,其中15例在preUAE和postUAE3个月,监测血清黄体生成素(LH)、卵泡刺激素(TSH)、泌乳素(PRL)、孕酮(Prog)、雌二醇(E2)等5种性激素变化。结果:47例(81%)UAE后恢复正常月经或明显改善,5例(8.6%)有一过性月经紊乱,3例(5.2%)出现闭经(年龄>45岁)。14例血清5种性激素在preUAE和postUAE变化差异无显著性意义(P>0.05),1例(年龄46岁)5种性激素preUAE处于卵泡期水平,postUAE3月处于绝经期。结论:UAE治疗子宫肌瘤后,大部分患者可恢复正常月经,对卵巢功能影响小,对血清性激素水平无明显影响,但极少数年龄大于45岁者postUAE可出现闭经。

Uterine Artery Embolization for Uterine Leiomyomas:Impact on Ovarian Function and Serum Level of Sex Hormones

Objective:To investigate the impact of uterine artery embolization (UAE) for leiomyomas of uterus on menses and ovarian function.Methods:UAE were performed on 66 patients with leiomyomas of uterus (mean age,39 years).Changes of menses were followed up within 3~33 months after UAE.Serum levels of sex hormone,including LH,FSH,PRL,Prog and E2 were tested before and 3 months after the procedure.Results:Forty-seven patients (81%) with menorrhagia resumed normal menses after UAE,and transient menstrual disorder occurred in 6 patients (8.6%).Only 3 patients (5.2%) aged over 45 years became menopausal following the procedure.Serum levels of sex hormones had no significant difference before and 3 months after UAE (P>0.05) in 14 patients.One patient aged 46 years whose hormone profile was in follicular phase before embolization became menopausal 3 months after UAE.Conclusion:UAE for uterine leiomyomas has minimal impact on ovarian function.Most patients could resume normal menses and had no change in serum levels of sex hormones.However,For patients aged 45 or older,there is possibility of menopause.