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目的探讨促性腺激素释放激素激动剂(GnRHa)治疗子宫内膜异位症时性激素水平及骨密度水平的变化。方法选择60例子宫内膜异位症患者,分为A、B 2组,各30例,另有30例健康女性为对照组(C组)。A组给予醋酸亮丙瑞林治疗,B组给予醋酸亮丙瑞林联合7-甲基异炔诺酮片进行反加治疗,C组不做任何治疗。观察临床疗效,检测治疗后卵泡刺激素(FSH)、黄体生成素(LH)、血清雌二醇(E2)、孕激素(P)以及骨密度水平。结果A、B 2组临床疗效无统计学差异;A、B 2组治疗4、12周后,FSH、LH、E2、P水平均较治疗前及C组明显下降,差异有统计学意义;治疗4、12周时,B组E2、P水平高于A组,差异有统计学意义;2组治疗后骨密度水平较治疗前无明显下降。结论 GnRHa治疗子宫内膜异位症可使FSH、LH、E2、P水平下降,联合反加疗法可减轻雌激素下降程度,减少骨质流失。
Objective To investigate the changes of sex hormone levels and bone mineral density (BMD) in patients with endometriosis treated with gonadotropin-releasing hormone agonist (GnRHa). Methods Sixty patients with endometriosis were selected and divided into groups A and B 2, 30 cases each, and 30 healthy women as control group (C group). Group A was treated with leuprolide acetate, group B was given leuprolide combined with 7-methyl-norethindrone anti-addictive treatment, and group C did not make any treatment. The clinical curative effect was observed. The follicle stimulating hormone (FSH), luteinizing hormone (LH), serum estradiol (E2), progesterone (P) and bone mineral density were measured after treatment. Results There was no significant difference in clinical efficacy between groups A and B 2. The levels of FSH, LH, E2 and P in group A and group B after 4 and 12 weeks of treatment were significantly lower than those before treatment and group C, respectively At 4 and 12 weeks, the levels of E2 and P in group B were higher than those in group A, and the difference was statistically significant. The bone mineral density of group B did not decrease significantly after treatment. Conclusions GnRHa can reduce the levels of FSH, LH, E2 and P in the treatment of endometriosis. Combined anti-endotherapy can reduce the decline of estrogen and reduce the bone loss.