三苯氧胺、丹那唑治疗子宫内膜异位症血清雌、孕激素及子宫内膜雌孕激素受体的变化

CHANGES OF SERUM ESTRADIOL AND PROGESTERONE LEVELS,ENDOMETRIUM ESTROGEN AND PROGESTERONE RECEPTOR CONCENTRATIONS DURING THE TREATMENT OF ENDOMETRIOSIS

本文收集腹腔镜或手术证实为子宫内膜异位症患者４３例，随机分成三组，分别应用丹那唑３个月，三苯氧胺３个月和三苯氧胺６个月治疗，随访治疗效果，并测定了外周静脉血血清雌二醇、孕酮水平及于宫内膜雌、孕激素受体水平。结果表明：三组治疗痛经缓解率为９０．０％～１００．０％，异位结节缩小率达４１．７％～５０．０％，受孕率为１３．３％～２８．６％。治疗后，丹那唑组血清孕酮下降（Ｐ＜０．１０），三苯氧胺３个月组血清雌二醇升高（Ｐ＜０．１０），６个月组血清雌二醇下降（Ｐ＜０．０５），对子宫内膜雌激素受体改变以丹那唑及三苯氧胺６个月组明显（Ｐ＜０．００５），孕激素受体三组均发生改变（Ｐ＜０．０１～０．００５）。结果提示：丹那唑和三苯氧胺对子宫内膜异位症有一定治疗效果，其作用机理除与抑制卵巢激素分泌有关外，可能对异位灶有直接作用。

orty-three patients with endometriosis diagnosed either by laparotomy or laparoscopywere randomized into three groups to study the efficacy of different therapeutic regimens,changes inserum estradiol(E2) and progesterone(P) levels,and estrogen anQ progesteronereceptor(ER and PR)concentrations of endometrium,in group 1 oral danazol was given200mg three times daily for three months;group 2,tamoxifen 1 0mg twice a day for threemonths; and group 3 tamoxifen 10mg twice a day for six months, The levels of serum E2and P and endometrium ER and PR concentrations were determined before and after treat-ment. Results indicated that dysmenorrhea decreased 90.0%～100.0%,endometrial focusdecreased 41.7%～50.0%while gestation rate was 13.3%～28.6%。 The levels of serum Pdecreased in group 1(P>0.10).and Serum E2 decreased in group 3(P<0. 05); The concentrations of ER in endometrium decreased in group 1 and group 3 (P<0. 005).The concen-trations of PR inendometrium decreased in alI three groups(P<0. 01～0. 005).The datashowed that danazol and tamoxifen may have a direct inhibitory effect on the endometriumand that the course of treatment of endometriosis with danazol was suggested to be threemonths and with tamoxifen, six months.