醋酸甲羟孕酮治疗子宫内膜不典型增生的剂量选择

Dose Selection of Medroxyprogesterone Acetate in the Treatment of Atypical Endometrial Hyperplasia

目的探讨用不同剂量醋酸甲羟孕酮治疗子宫内膜不典型增生的临床效果。方法选取自2012年1月—2018年12月期间53例子宫内膜不典型增生患者于本院行醋酸甲羟孕酮保留生育能力治疗。根据醋酸甲羟孕酮的剂量分组,将患者分为A组(250 mg/d,n=37)和B组(500 mg/d,n=16),对比两组患者的疗效及药物不良反应。结果保守治疗3个月后,A组及B组的完全缓解率分别为32.43%、68.75%,组间相比差异具有统计学意义;保守治疗6个月后,A组与B组的完全缓解率为70.27%、81.25%,组间相比差异不具有统计学意义。两组的药物不良反应发生率及完全缓解时间差异不具有统计学意义。结论在治疗子宫内膜不典型增生的初期阶段,高剂量甲羟孕酮完全缓解率高。但是两组完全缓解时间差异无统计学意义。醋酸甲羟孕酮500 mg/d可作为子宫内膜不典型增生保守治疗的初始剂量,不增加药物不良反应。

Objective To analyze the clinical efficacy of different doses of medroxyprogesterone acetate on atypical endometrial hyperplasia.Methods An analysis of 53 patiens with atypical endometrial hyperplasia who received medroxyprogesterone acetate fertility-preserving therapy from January 2012 to December 2018.According to the dosage of medroxyprogesterone acetate,the patients were divided into group A(250 mg/d,n=37)and group B(500 mg/d,n=16),the efficacy and adverse drug reactions of the two groups were compared.After three months of conservative treatment,the complete remission rates of group A and group B were 32.43%and 68.75%,reached statistical significance between groups.After six months of conservative treatment,the complete remission rate of group A and group B was 70.27%and 81.25%,which were not statistically significant between groups.Incidence of adverse drug reactions and time of complete remission in the two groups were not statistically significant.Conclusion The rate of complete remission was high in the early stage of the treatment of atypical endometrial hyperplasia with high dose medroxyprogesterone acetate,but there was no significant difference in the time of complete remission between the two groups.Medroxyprogesterone acetate 500 mg/d can be used as the initial dose for conservative treatment of atypical endometrial hyperplasia.