甲基睾丸素联合米非司酮对围绝经期功能性子宫出血患者预后的影响

Effect of Methyltestosterone Combined with Mifepristone on the Prognosis of Patients with Perimenopausal Dysfunctional Uterine Bleeding

目的探究甲基睾丸素联合米非司酮对围绝经期功能性子宫出血(dysfunctional uterine bleeding,FUB)患者预后的影响。方法将2014年1月-2016年1月入院的104例围绝经期FUB患者采用随机数表法分为研究组和对照组,每组52例。对照组采用米非司酮治疗,研究组联合甲基睾丸素治疗。观察2组疗效、症状缓解时间,评估患者治疗前后子宫内膜及激素水平[孕酮(P)、雌二醇(E2)]变化情况,记录2组随访1年复发率、骨密度。结果 (1)治疗3.5个月后,研究组较对照组治疗总有效率高、症状缓解时间短(P<0.05);(2)治疗3.5个月后,2组P、E2水平及子宫内膜厚度均较治疗前下降(P<0.05),且研究组降幅较对照组大(P<0.05);(3)随访1年后,研究组复发率较对照组低(P<0.05),研究组腰椎前后位、股骨颈、大粗隆骨密度均高于对照组(P<0.05)。结论甲基睾丸素联合米非司酮治疗围绝经期FUB效果更显著,且对降低患者复发率和骨量丢失有积极影响,预后状况良好。

Objective To explore the effect of methyltestosterone combined with mifepristone on the prognosis of of patients with perimenopausal dysfunctional uterine bleeding （FUB）. Methods From January 2014 to January 2016, 104 perimenopausal FUB patients treated in our hospital were randomly divided into study group （52 cases） and control group （52 cases）. Both groups were given mifepristone, beside, the study group was given additional methyltestosterone. The curative effects and remission time in the two groups were observed, the changes of endometrium and hormone levels [progesterone （P） and estradiol （E2）] were evaluated before and after treatment, and after 1 year follow-up, the recurrence rates and bone mineral density in the two groups were recorded and compared. Results After 3.5 months treatment, the total effective rate in the study group was higher than that in the control group, and the remission time in the study group was less than that in the control group （P〈0.05）, the levels of P and E2 and thickness of endometrium in the two groups were all decreased, and the decrease in the study group were greater than those in the control group （P〈0.05）, after 1 year follow-up, the recurrence rate of the study group was lower than that of control group （P〈0.05）, the bone mineral density of anteroposterior projection of lumbar vertebrae, femoral neck and trochanter in the study group was higher than that in the control group （P〈0.05）. Conclusion Methyl testosterone combined with mifepristone whose curative effect on perimenopausal FUB is more signifcant, has not only positive effect on reducing recurrence rate and bone loss, but also good prognosis.