Toward removing uterine fibroids without surgery: subcutaneous infusion of a luteinizing hormone-releasing hormone agonist commencing in the luteal phase.
Toward removing uterine fibroids without surgery: subcutaneous infusion of a luteinizing hormone-releasing hormone agonist commencing in the luteal phase.
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无需手术即可切除子宫肌瘤：从黄体期开始皮下注射黄体生成素释放激素激动剂。
DOI：
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发表时间：
1986
影响因子：
5.8
通讯作者：
H. Fraser
中科院分区：
文献类型：
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作者：
D. Healy;S. Lawson;M. Abbott;D. Baird;H. Fraser
在5名妇女中，间断皮下注射LHRH激动剂可减少子宫肌瘤的大小。在月经周期第21天开始使用LHRH激动剂布舍瑞林可诱导血浆LH和FSH浓度显著升高，随后雌二醇（E2）和孕酮升高。开始布舍瑞林给药后120 h，LH和FSH水平降至正常范围内，尽管继续给予激动剂。月经后，周期性促性腺激素和类固醇浓度出现明显持续抑制：布舍瑞林治疗20周期间，FSH、LH和E2的平均值分别为4.9 +/- 0.5（+/- SE）mIU/ml、5.9 +/- 0.6 mIU/ml和47.9 +/- 10.8 pg/ml。治疗期间，116次每周观察中有98次E2浓度保持在50 pg/ml以下。通过超声或妇科检查评估，布舍瑞林给药8周或10周后子宫肌瘤缩小。与初始体积相比，布舍瑞林输注20周后的平均子宫肌瘤体积从220 +/- 51降至98 +/- 26 cm 3，为治疗前体积的39.4 +/- 6.9%。我们的结论是，在黄体期开始皮下注射LHRH激动剂可明显减少子宫肌瘤的大小，抑制但不能消除垂体和卵巢功能，值得进一步评价作为子宫肌瘤切除术或子宫切除术的一种选择或替代疗法。
Intermittent sc injection of a LHRH agonist reduced uterine fibroid size in 5 women. Commencement of the LHRH agonist buserelin on day 21 of the menstrual cycle induced a marked increase in plasma LH and FSH concentrations, followed by rises in estradiol (E2) and progesterone. LH and FSH levels fell to within the normal range by 120 h after beginning buserelin, despite continuing administration of the agonist. After menstruation, marked sustained suppression of cyclical gonadotropin and steroid concentrations occurred: mean values of FSH, LH, and E2 were 4.9 +/- 0.5 (+/- SE) mIU/ml, 5.9 +/- 0.6 mIU/ml, and 47.9 +/- 10.8 pg/ml, respectively, during the 20 weeks of buserelin treatment. During treatment, E2 concentrations remained below 50 pg/ml in 98 of 116 weekly observations. Uterine fibroids shrank after 8 or 10 weeks of buserelin administration, as assessed by ultrasound or gynecological examination. Compared to their initial volume, mean uterine fibroid volume after 20 weeks of buserelin infusion decreased from 220 +/- 51 to 98 +/- 26 cm3, which was 39.4 +/- 6.9% of the pretreatment volume. We conclude that sc administration of a LHRH agonist beginning in the luteal phase markedly reduced the size of uterine leiomyomata, suppressed, but did not abolish, pituitary and ovarian function, and warrants further evaluation as an option or adjunctive therapy to uterine myomectomy or hysterectomy.