激素替代治疗对绝经后子宫肌瘤患者的影响分析

Effect of hormone replacement therapy on the uterine structure for patients with myoma of uterus in postmenopause

目的 探讨激素替代治疗对绝经后子宫肌瘤患者的影响.方法 选取确诊绝经后期的子宫肌瘤患者80例,采用随机双盲法分为研究组43例（给予激素替代治疗,小剂量雌二醇联合地屈孕酮）和对照组37例（给予谷维素治疗）.比较治疗12个月后两组激素水平（卵泡刺激素、黄体生成素）、子宫结构（子宫肌瘤体积、子宫内膜厚度、子宫体积）.结果 在患者激素水平方面,研究组患者黄体生成素（12.19±2.39）U/L,卵泡刺激素（13.14±5.29）U/L;对照组患者黄体生成素（15.09±3.18）U/L,卵泡刺激素（22.19±6.25）U/L,研究组较对照组均明显降低（t=11.312、10.583,均P〈0.05）.在患者子宫结构方面,研究组患者子宫肌瘤体积（6.45±2.21）cm3,子宫体积（45.56±15.17）cm3,子宫内膜厚度（2.84±1.07）mm;对照组患者子宫肌瘤体积（5.92±1.81）cm3,子宫体积（38.25±10.52）cm3,子宫内膜厚度（2.36±0.82）mm,研究组较对照组子宫肌瘤体积无明显增加,差异无统计学意义（t=1.043,P〉0.05）,子宫体积及子宫内膜厚度略增加,差异均有统计学意义（t=8.492、7.954,均P〈0.05）.结论 在绝经后子宫肌瘤患者子宫功能结构方面,激素替代治疗可改善子宫结构功能,并且不增大子宫肌瘤,同时降低卵泡刺激素、黄体生成素水平.

Objective To investigate the effect of hormone replacement therapy on the uterine structure for patients with myoma of uterus in postmenopause. Methods According to the method of treatment, 149 patients were divided into study group （ 73 cases） and control group （ 76 cases ）. The control group was given oryzanol, while the study group was given hormone replacement threapy （ little dose of estradiol combined with dydrogesterone）. The sex hormone levels（ LH, FSH）,uterine structure（ volume of uterine fibroids, endometrial thickness, uterine volume） were compared. Results The sex hormone levels of LH, FSH in the study group were （ 12.19 ±2.39 ） U/L, （ 13.14 ± 5.29 ）U/L, respectively, which were lower than those in the control group [ （15.09 ± 3.18 ）U/L, （22.19 ±6.25 ）U/L ] , the differences were statistically significant （ t = 11.312,10. 583, all P 〈 0.05 ）. The volume of uterus fibroids, volume of uterine,endometrial thickness in the study group were （6.45 ± 2.21 ） cm3, （45. 56 ± 24. 17） cm3, （2. 84± 1.07） mm,respectively, which in the control group were （ 5.92 ± 2. 31 ） cm3, （ 38. 25 ± 20. 52 ） cm3, （ 2. 36 ± 0.82）ram, respectively. Compared with the control group, the study group had bigger uterine and endometrial thickness, the differences were statistically significant （ t = 8. 492,7. 954, all P 〈 0.05 ）, while the volume of uterus uteroids had no statistically significant difference between the two groups （ t = 1. 043, P 〉 0.05 ）. Conclusion On the uretine structure of patients with myoma of uterus in postmenopause, compared with traditional oryzanol, hormone replacement can improve the status of uretus structure and function, and resist the side - effect of enlargement of the volume of uretus fibroids. There is significant advance for hormone replacement therapy on the uterine structure of patients with uretus fibroids in postmenopause.