子宫内膜轻度不典型增生药物治疗的效果探讨

Comparision of the effect of three conservative treatments on mild atypical endometrial hyperplasia

目的比较醋酸戈舍瑞林、醋酸甲羟孕酮片以及复方醋酸棉酚片3种药物治疗子宫内膜轻度不典型增生的临床疗效。方法选择2008年1月至2013年12月新疆医科大学第一附属医院收治的未绝经及要求保守治疗的子宫内膜轻度不典型增生患者73例,根据治疗方法的不同,将研究对象分为三组:A组:醋酸戈舍瑞林组25例;B组:醋酸甲羟孕酮组24例;C组:醋酸棉酚组24例。所有患者用药疗程为3个月,治疗后均行宫腔镜检查+全面诊刮。对比3种药物治疗3个月后及随访1年后的疗效。结果 1 A组、B组和C组三组完全缓解率分别为:100.00%(25/25),70.83%(17/24)和83.33%(20/24)。治疗3个月后三组疗效差异有统计学意义(P=0.019)。A组和B组差异有统计学意义(P=0.004),A组完全缓解率高于B组;2随访1年后A组、B组和C组三组完全缓解率分别为:72.00%(18/25),64.71%(11/17)和100.00%(20/20)。3种治疗方法的疗效差异有统计学意义(P=0.021)。A组和C组、B组和C组之间差异有统计学意义(P=0.011;P=0.004),C组的完全缓解率高于A组及B组;3随访1年中3种治疗方法疾病复发率:A组20.00%(5/25)、B组0%(0/17)和C组0%(0/20)。A组的疾病复发率高于另外两组。结论 1复方醋酸棉酚片可能成为年龄≥45岁的子宫内膜轻度不典型增生女性的一个较好的保守治疗方法;2 GnRH-a治疗子宫内膜轻度不典型增生短期效果较好,但有较高的疾病复发率。

Objective To compare the effect of Goserelin acetate,Medroxyprogesterone acetate and Gossypol acetic acid on the treatment of mild atypical endometrial hyperplasia.Methods A study was carry out on 73 cases with atypical endometrial hyperplasia patients who admitted to the First Affiliated Hospital of Xinjiang Medical University from Jan.2008 to Jun.2013.According to the different treatment methods,73 cases were divided into three groups：Group A：Goserelin acetate group,25cases;Group B：medroxyprogesterone acetate group 24cases;Group C：Gossypol acetic acid group,24 cases.After three months treatment,73 cases were examined by hysteroscopy and histopathological diognosis was made.All cases were under follow-up for one year and the therapeutic effects was compared.Results 1 The complete remission rates of the three groups were：100.00%（25/25）,70.83%（17/24）and 83.33%（20/24）,respectively（P=0.019）.The complete remission rates of Group A was significantly higher than Group B（P=0.004）.2 After one year follow-up the complete remission rates of the three groups were：72.00%（18/25）,64.71%（11/17）and 100%（20/20）,with a statistically significant difference（P=0.021）.A significant difference between Group A,Group C and Group B,（P=0.011;P=0.004）.The complete remission rates of Group C was the highest among the three groups.3 The recurrent rate after 1years was 20.00%（5/25）in Group A,0%（0/17）in Group B and 0%（0/20）in Group C.Conclusions 1 Compound Gosspol Acetate Tablets may be a better treatment for patients older than 45 years old.2 Goserelin acetate had better short-term effect,but the recurrent rate was higher than the other two methods in the treatment of mild atypical endometrial hyperplasia.