替勃龙对绝经后子宫肌瘤的影响

The effect of Tibolong on hysteromyoma after menostasia

目的:观察替勃龙(7-甲基异炔诺酮)激素替代治疗(HRT)对绝经后子宫肌瘤的影响。方法:选择因绝经相关症状需HRT的自然绝经且有子宫肌瘤的妇女98例为研究对象,口服替勃龙2.5 mg,每日1次,3个月后开始隔日口服2.5mg,连续12个月。分别于治疗前及治疗3、6及12个月后各随访1次,检测血清卵泡刺激素(FSH)、雌二醇(E2)水平,观察Kupperman评分、子宫肌瘤体积及子宫内膜的变化并进行乳房检查。结果:64例患者完成了12个月的临床观察,因各种原因中途退出治疗或失访者共有34例。用药后Kupperman评分显著降低(P<0.01),血清FSH水平显著降低(P<0.05),而血清E2水平无明显变化(P>0.05),子宫肌瘤体积及子宫内膜厚度无明显变化(P>0.05),乳腺未发现明显异常。结论:替勃龙能有效改善绝经相关症状,但对绝经后子宫肌瘤的影响不大。

Objective： To study the effects of Tibolong （7 - methyl iso norethindrone） hormone replacement therapy （HRT） on hysteromyoma after menostasia. Methods： A total of 98 eases with hysteromyoma after natural menostasia, who needed to HRT for meno- pause -related symptoms, were selected as the object of the study. The patients took orally Tibolong 2. 5mg, 1 times a day. After 3 months, they started to take orally 2. 5 mg every other day, constantly for 12 months. Before treated and after treated for 3, 6 and 12 months, the pa- tients were follow - up survey once. The levels of Serum follicle - stimulating hormone （FSH） and estradiol （ E2 ） were examined. Kupper- man score, volume of hysteromyoma and endometrial changes were observed, and breast was examined. Results ： Of the 98 patients, 64 pa- tients completed the clinical observation of 12 months, 34 cases lost in the middle of treatment for various reasons. After treated 3, 6 and 12 months, Kupperman score were significantly reduced （ P 〈 0. 01 ） compared with none treated. The level of serum FSH was significantly de- creased （ P 〈 0.05 ） . But level of serum E2 was not significantly change （ P 〉 0. 05 ） . The volume of hysteromyoma and endometrial thick- ness were not significantly change （P 〉 0. 05） . And mammary gland was not found obvious abnormalities. Conclusion： Tibolong can effec- tively improve symptoms related menostasia, but has little effect on hysteromyoma after menostasia.