露特尼治疗围绝经期功能性子宫出血30例

THE EFFICACY OF NOMEGESTROL ACETATE IN THE TREATMENT OF DYSFUNCTIONALUTERINE BLEEDING OF PERIMENOPAUSAL WOMEN

目的：本文对３０例围绝经期功能性子宫出血用露特尼治疗，以观察其临床疗效。方法：患者自月经周期ｄ１５至ｄ２４服露特尼５ｍｇ／ｄ，撤退出血ｄ１５起重复，共４个周期。结果：治疗后患者均可按时出血，出血天数由（１２．１±１１．１）ｄ减少至（６．２±２．１）ｄ（Ｐ＜０．０５），经量过多及经期延长者１４例（４６．７％）及１６例（５３．３％）分别减少至３例（１０．０％）及０（Ｐ＜０．００１）。治疗后增殖期子宫内膜由１９例（６３．３％）明显减少至９例（３１．０％），分泌期内膜由５例（１６．１％）增加至１８例（６２．１％）（Ｐ＜０．０５），且有３例内膜单纯增生患者在治疗后增生消失。血糖代谢无明显改变，ＨＤＣＣ降低（１．３±０．３→１．２±０．２Ｐ＜０．０５）较为明显。临床耐受性高。结论：对围绝经期功能性子宫出血患者及需长期孕激素治疗患者，可选用露特尼治疗。

OBJECTIVE :To study the efficacy of nomegestrol acetate(Lutenyl)in treatment of dysfunctional uterine bleeding in perimenopausal women. METHODS :30 patients with menopausal uterine bleeding were treated with nomegesterol acetate in a daily dose of 5 mg on 15th24th days of menstruation and repeated on 15th day of withdraw bleeding until a total of 4 cycles were completed. RESULTS :First,regular menstruation was rebuilt in all patients and the mean bleeding period decreased from(12.111.1)d to (6.22.1)d(P<0.05).The cases of menorrhagia and metrorrhagia were decreased from 14 to 3 and 16 to 0(P<0.001)respectively.Second,the cases of proliferative endometria decreased from 19 to 9 and the cases of secretive endometria increased from 5 to 18(P<0.05).Endometrial hyperplasia without atypia of 3 patients was disappeared after treatment.Third,no significant effect on carbohydrate metabolism was observed.Fourth,a better clinical tolerance was obtained. CONCLUSION :Normegestrol acetate may be selected to substit