绝经激素治疗对围绝经期子宫肌瘤患者的影响

Effects of menopausal hormone treatment on patients with uterine fibroids during peri-menopausal period

目的观察绝经激素治疗对围绝经期子宫肌瘤患者的影响。方法选择2010年1月~2014年9月于南京医科大学附属无锡妇幼保健院就诊的围绝经期子宫肌瘤患者193例,采用雌孕激素周期序贯法。分别于服药前和服药后3、6、9、12和24个月采用Kupperman评分法评价用药前后围绝经期综合征症状,采用阴道B超监测子宫体积、子宫肌瘤体积、子宫内膜厚度,采用化学发光法检测血清卵泡生成激素、黄体生成素和雌二醇水平。结果用药后患者Kupperman总分及各项评分均较用药前显著降低(P<0.05)。用药后9、12、24个月患者子宫体积较用药前缩小,差异有统计学意义(P<0.05),而用药后患者子宫内膜厚度及子宫肌瘤体积与用药前相比,差异无统计学意义(P>0.05)。用药后患者卵泡生成激素水平较用药前显著降低(P<0.05),而黄体生成素和雌二醇水平与用药前比较差异无统计学意义(P>0.05)。结论对围绝经期子宫肌瘤患者进行绝经激素治疗,能够有效改善围绝经期症状,且对子宫肌瘤无明显影响。

Objective To investigate the effect of menopausal hormone treatment on patients with uterine fibroids during peri-menopausal period. Methods 193 patients with uterine fibroids during peri-menopausal period treated in Wuxi Maternal and Child Health-Care Hospital Affiliated to Nanjing Medical University from January 2010 to September 2014 were selected. All patients received estrogen progesterone cycle sequential therapy. The Kupperman score was used to evaluate the symptoms of perimenopausal syndrome before medication and 3, 6, 9, 12, 24 months after medication. Uterine volume, fibroid volume and endometrial thickness were monitored by vaginal ultrasound. The levels of serum follicle stimulating hormone, luteinizing hormone and estradiol were measured by chemiluminescent immunoassay. Results After medication the total score and item scores of Kupperman were significantly lower than before medication （P 〈 0.05）. 9, 12, 24 months after medication the uterine volumes were significantly smaller than before medication （P 〈 0.05）, however, there were no significant differences in endometrial thickness and fibroid volume among before and after medication （P 〉 0.05）. After medication the levels of follicle-stimulating hormone were significantly lower than before medication （P 〈 0.05）, however, there were no significant differences in luteinizing hormone and estradiol levels among before and after medication （P 〉 0.05）. Conclusion Menopausal hormone treatment for patients with uterine fibroids during peri-menopausal period can effectively improve peri-menopansal symptoms, but has no obvious effect on the uterine fibroids.