甲氨蝶呤局部注射治疗子宫腺肌病的研究

Effects of MTX regional treatment in adenomyosis

目的 探讨甲氨蝶呤 (MTX)局部注射治疗子宫腺肌病的可行性。方法 2 0例子宫腺肌病的病人 ,每月月经干净 3～ 5天时 ,在子宫病灶局部及周围注射MTX 5 0mg ,连续 6个月。治疗前、后行子宫附件阴式B超检查、子宫病灶局部穿刺活检及血常规、肝肾功能、性激素检查 ,同时观察临床症状。结果 治疗前与MTX治疗后3个月比较B超测子宫长度、子宫厚度、子宫后壁厚度差异有显著性意义 (P <0 0 5 ) ;与治疗后 6个月比较子宫长度差异有非常显著性意义 (P <0 0 1) ,子宫厚度、子宫后壁厚度减少 ,差异有显著性意义 (P <0 0 5 )。治疗前与治疗后Hb、WBC、Pt、ALT、BUN、FSH、LH、E2 、T、P差异无显著性意义 (P >0 0 5 ) ,仅PRL在治疗后 3个月较治疗前差异有显著性意义 (P <0 0 5 )。结论 局部应用MTX治疗子宫腺肌病将是一个有发展前景的治疗手段。

Objective To study the effects of Methotrexate(MTX) local use on adenomyosis.Methods 50mg MTX was injected in or on the peripheral of the focus in 20 patients with adenomyosis.The injection was performed on the 3rd～5th day after menstruation every month and continued for 6 months.Vaginal B ultrasonography was used to examine the uterus and adnexa,foci were punctured and performed pathological examination.In addition,blood routine,liver function,renal function and sex hormone were all detected before and after the treatment.The clinical signs were investigated simutaneously.Results After 3 month treatment,the length of uterus,the thickness of uteral wall and posterior wall were all significantly different from those before treatment (P<0 05);The difference in the length of uterus was more significant after 6-month treatment (P<0 01) and in this period,the decrease of the thickness was still significant(P<0 05).While before and after treatment,Hb?WBC?Pt?ALT?BUN?FSH?LH?E 2?T?P showed no significant difference(P>0 05).Only PRL was significantly different after 3 month treatment (P<0 05).Conclusion Local use of MTX on the treatment of adenomyosis is a perspective method.