国产黄体生成素释放激素─A治疗子宫内膜异位症的临床研究

Clinical investigation for patients of endometriosis with domestic luteinizing hormone releasing hormone analog (Alarelin).

应用不同剂量（１００μｇ／ｄ，２００μｇ／ｄ）的国产黄体生成素释放激素－Ａ（ＬＨＲＨ－Ａ）治疗子宫内膜异位症６６例，其中Ⅰ期９例，Ⅱ期４７例，Ⅲ期１０例。合并不孕症２９例，子宫肌腺症１０例。结果表明，５００μｇ／ｄ组对卵巢内膜囊肿的疗效最佳，但对子宫腺肌症的效果不明显，停药后妊娠７例，占２４％（７／２９）。所用ＬＨＲＨ－Ａ的３种剂量均抑制Ｅ２，Ｐ，ＰＲＬ的分泌，使血中生殖激素下降，排卵抑制和卵巢内膜囊肿缩小，对血胆固醇有升高作用，临床主客观症状体征以５００μｇ／ｄ组变化最为明显。

Sixty-six cases of endometriosis (EM ) were classified into 3stages by American Fertility Society Classification(stage 19 cases, Ⅱ 47,Ⅲ 10)in July 1989 to Dec.1992.29cases (43. 9%) of them accompanied with infertility. 10 with adenomyosis.The study purpose is to observe the clincal efficacy of Alarelin of different dosages (100μg, 200μg,500μg daily) , serum endocrine and total cholesterol after treatment of 6 months. The results showed : estradiol ( E2 ) , progesterone ( P ) ,prolactin ( PRL) differently decreas ed in 3 dosages ( P<0.05 ) , meanwhile,the total cholesterol increased ( P<0.05 ) .The best danage is 500μg of Alarelin on endometriomas,but no effective on adenomyosis,7cases of 29 ( 24.1%)get pregnancy (7 cases: 4cases were delivered at full term, 2 cases spontaneous abortion, 1 case artificial abortion) .The authors also found that 16cases.( 24.2%) were diagnosed as hyperprolactinaemia and these patients PRL value decreased to normal after treatment . The authors concluded that the ovulation was suppressed due to decrease of reproductive hormone and endometriomas shrank , especially in 500μg group of Alarelin, but the total cholesterol increased during treatment.