简体中文

论著-头颈部

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

作者:周传亚

所属单位:河南省濮阳市妇幼保健院妇二科 (河南 濮阳 457600)

PDF

摘要

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 significant, has not only positive effect on reducing recurrence rate and bone loss, but also good prognosis.

【关键词】甲基睾丸素;米非司酮;围绝经期功能性子宫出血;预后

【中图分类号】R711.5

【文献标识码】A

【DOI】10.3969/j.issn.1009-3257.2018.03.019

前言

FUB发病机制在于围绝经期女性下丘脑-垂体-卵 巢轴的功能失调,使卵巢功能下降,导致不规则子宫 出血,月经周期紊乱等,影响患者身心健康[1]。临床 治疗此病的主要手段分为2类,手术因创伤大、恢复 期长故患者接受度较低;保守治疗包括对症治疗出血 和激素补充等,经临床观察疗效良好,但对其预后状况的相关研究较少。基于此,本研究选取我院收治的 围绝经期FUB患者104例进行研究,以探讨甲基睾丸 素联合米非司酮对围绝经期FUB患者疗效及预后的影 响,现报告如下。