三烯高诺酮治疗子宫肌瘤31例

目的研究三烯高诺酮治疗子宫肌瘤的临床疗效及作用机制.方法31例子宫肌瘤患者服用三烯高诺酮2.5mg,每周2次,共6个月,停药后随访6个月,观察肌瘤症状,B超监测子宫和肌瘤大小,检测性激素等.结果58.84%患者出现闭经,维持月经者肌瘤症状亦明显改善,停药6个月内23.08%症状复发.不良反应以增重、皮肤改变为主,均可逆.子宫体积缩小在治疗3个月和6个月时分别为22.6%和31.7%,肌瘤缩小分别为33.4%和50.2%(P均＜0.05).停药6个月后与停药时比较子宫和肌瘤体积反弹19.2%和44.7%(P均＜0.05),仍比治疗前小.肌壁间肌瘤(P＜0.05)或直径小于4cm的肌瘤缩小较明显.治疗前后卵泡刺激素(FSH)和黄体生成激素(LH)明显下降(P＜0.05),雌二醇(E2)和孕酮(P)亦有所降低(P＞0.05),T,PRL略升高(P＞0.05).结论三烯高诺酮可通过影响性激素水平及其在靶细胞的作用而有效治疗子宫肌瘤,并对肌壁间和较小肌瘤疗效较佳.

Gestrinone in treatment of 31 cases of uterus myoma

Objective:To investigate clinical efficacy of gestrinone in treatment of uterus myoma and its mechanism. Methods: 31 patients with uterus myoma were treated with gestrinone 2.5 mg twice weekly for 6 months and followed up for another 6 months after treatment.The size of myoma and uterine were monitored by ultrasonotomography and the serum sex hormone level was determined. Results: Amenorrhea occurred in 58.84%patients,the symptom of myoma was improved obviously in the balance.Reduction in myoma volume during 3 and 6 months therapy were 22.6%and 31.7%respectively and the uterine volume were also reduced by 33.4%and 50.2%respectively( P<0.05 ) at the same time.The myoma and uterine volume regained by 44.7%and 19.2%respectively on 6 months post-treatment ( P <0.05),E_2 and P were also decreased ( P> 0.05),the serum level of T and PRL were increased. Conclusion: Through reducing serum sex hormone level,the volume of uterus and uterine myoma can be reduced obviously by gestrinone therapy especially intramural or small myoma.