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【目的】比较两种反向添加方案对促性腺激素释放激素(GnRH)抑制剂治疗盆腔子宫内膜异位症(EM)术后患者性激素和骨质密度的影响。【方法】收集在本院因重度盆腔 EM行保守性腹腔镜手术治疗并有生育要求的女性患者80例,按随机数字法分对照组和试验组,每组40例。对照组术后 d3给予 GnRH-a 3.6 mg/28 d,共7次；试验组在对照组的基础上加用维生素D3。每次用药前及第4周、12周、16周、20周、24周和月经复潮常规复查超声及卵泡刺激素(FSH)、黄体生成素(LH)、E2变化及骨密度扫描；比较两组患者骨质疏松防治效果。【结果】①两组治疗后第4周、12周、16周、20周、24周血清E2、FSH、LH 水平均比用药前显著降低差异有显著性(P 0.05)。但月经复潮后 E2、FSH、LH 又恢复至用药前水平,治疗前后比较差异亦无显著性差异(P >0.05)。②两组用药后4周、8周、12周骨密度与治疗前比较差异无统计学意义(P >0.05)；用药后16周、20周、24周及月经复潮后,两组骨密度明显降低,对照组与治疗前及试验组相比差异有统计学意义(P 0.05)。【结论】对于盆腔 EM术后患者使用 GnRH 抑制剂联合小剂量雌激素、钙剂及维生素D3预防低雌激素水平及骨质疏松效果更佳。“,”Obj ective]To compare the effect of two reverse added solutions on sex hormone and bone mineral density upon gonadotropin-releasing hormone (GnRH)inhibitors in the treatment of pelvic endometriosis (EM).[Methods]Eighty patients with requirement for fertility who were treated with conservative laparoscopic surgery for severe pelvic endometriosis were col-lected,and were randomly divided into control group and experimental group,40 cases in each group.The control group were given with the GnRH-a 3.6mg/28d ,seven times totally.On the basis of the control group,the experimental group was added with vitamin D3 .At time before each treatment and on the fourth week,twelfth week,sixteenth week,twentieth week,twen-ty-fourth week and menstrual cycle ,the conventional ultrasound reexamination and follicle stimulating prime (FSH),luteini-zing prime (LH),the change of E2 and bone density scan were detected;osteoporosis prevention and treatment effect of two groups of patients were compared.[Results](1)In the two groups ,at 4th w,12th w,16th w,20th w and 24th w after the treatment,the levels of serum E2 ,FSH,LH were significantly reduced ,the difference was significant (P 0.05).(2)Comparing with those before treatment,the difference of bone density of the two groups at 4th w,8th w,12th w after treatment were not statistically significant (P >0.05);16 weeks,20 weeks and 24 weeks after medication and the return of menses,the bone density in both groups was significantly decreased,the difference of the control had statistical significance comparing with those of the treatment group and that before treatment (P0.05).[Conclusion]GnRH inhibitor,combined with a small dose of estrogen,calcium and vitamin D3 in patients with pelvic EM is able to prevent low estrogen level and osteoporosis,the effect sounds better.