摘要
目的 了解国产黄体生成激素释放激素类似物 (LHRH -a)联合低剂量炔诺酮治疗子宫内膜异位症对生殖激素及腰椎骨量的影响。方法 对 110例内异症患者随机分为两组 ,A组 6 3例 ,采用LHRH -a 15 0 μg每日肌注加炔诺酮 2 5mg每日口服 ,B组 4 7例 ,单独应用LHRH -a肌注 ,疗程 3～ 6个月。放射免疫法测定血清FSH、LH、E2 、P、游离雌三醇 (FE3 )、游离睾丸酮 (FT)、骨钙素 (BGP)水平并比较阴道脱落细胞片型变化。双能X线吸收仪 (DEXA)测定两组患者腰椎2～ 4(前后位 )骨密度。结果 A组于给药 6小时后FSH、LH、E2 水平显著升高 ,但第 6天已不再升高 ;治疗 3个月后LH、E2 、P ,6个月后FSH、LH、E2 、P水平显著低于治疗前。B组于给药 6小时后FSH、LH、E2 、P水平显著升高 ,第 6天E2 仍显著高于治疗前 ;治疗 3个月后FSH、P ,6个月后FSH水平显著降低。二组阴道脱落细胞片型显示以中层细胞为主 ,伊红指数低。A组治疗 3个月后FE3 显著低于B组 ,而FT则显著高于B组。治疗 6个月后A组BGP水平低于B组。B组治疗 6个月后腰椎骨量丢失 (2 6 7±0 72 ) % ,显著低于治疗前。A组治疗 6个月后骨丢失 (0 2 4± 0 89) % ,与治疗前无显著差异。结论 国产LHRH -a联合低剂量炔诺酮治疗内异症的作用机制同样是通过药物的去卵巢?
Objective To study the effect of combining domestic LHRH-a with low-dose norethindrone on reproductive hormone and lumbar bone mineral density(BMD) in the treatment of endometriosis. Methods 110 women with endometriosis were randomized into two groups. Group A (n=63) were treated with LHRH-a(150μg/d intramuscular) plus oral norethindrone(2 5mg/d) and group B (n=47) received only LHRH-a(150μg/d) for 3 to 6 months. Serum FSH, LH, estradiol (E 2 ), progesterone(P), free-estriol (FE 3 ), free-testosterone (FT) and osteocalcin (BGP) of the two groups were assayed by radioimmunology and vaginal smears were also compared. Lumbar (L 2 -L 4 ) BMD was assayed by dual-energy X-ray absorptiometry (DEXA). Results\ In group A, significant increase of serum FSH, LH, E 2 level was observed 6 hours after administration, but it was not significant on the sixth day. Both serum LH, E 2 , P level 3 months after treatment and serum FSH, LH, E 2 , P level 6months after treatment were significantly lower than baseline. In group B, significant increase of serum FSH, LH, E 2 , P level was observed 6 hours after administration and the increase of serum E 2 was still significant on the sixth day. Both serum FSH, P level 3 months after treatment and serum FSH level 6 months after treatment were significantly lower than baseline. The vaginal smears of both groups showed a dominant middle layer cells and low eosinophilic index. FE 3 level of group A was significantly lower than that of group B while FT level was significantly higher 3 months after treatment. Serum BGP level of group A was lower than that of group B 6 months after treatment. Bone loss of group B was (2 67±0 72)% 6 months after treatment, which was significantly lower than baseline. A (0 24±0 89)% bone loss was observed in group A, but there was no difference compared to baseline. Conclusion\ The mechanism of combining domestic LHRH-a with low-dose norethindrone in the treatment of endometriosis is also through pharmic oophorectomy, its prevention effect of lumbar bone loss may be associated with the androgen action and deceleration of bone resorption.
出处
《中国实用妇科与产科杂志》
CAS
CSCD
北大核心
2002年第3期175-178,共4页
Chinese Journal of Practical Gynecology and Obstetrics
基金
上海市教育发展基金会资助 (基金编号 :97-66)
