Calvo Lugo G E, Sauceda González L F, Jiménez Perea M L, Díaz Arias F J
Servicio de Biología de la Reproducción Humana, CMN 20 de Noviembre ISSSTE, México, D.F.
Ginecol Obstet Mex. 2000 Jan;68:7-14.
The medical treatment of the pelvic endometriosis includes the hormonal therapy that attacks directly to the endometriosis lesions or indirectly it inhibits the endometrial proliferation and it induces atrophy through the estrogenic deprivation, or to inclination of a combination of these effects. The objective of the present study was to evaluate the effects of two gonadotrophin release analogs in the treatment of the endometriosis. 15 patients were studied in who the diagnosis settled down of endometriosis by means of laparoscope; these were formed two groups in aleatory form and there were administered to each one them nafarelin acetate in dose of 200 or 400 micrograms each 12 hours or goserelin acetate in dose of 3.6 mg every 21 days; the serum levels of the stimulating follicle, luteinizing, estradiol and prolactin hormones were determined at intervals of four weeks and the secondary effects of these drugs were reported. There were carried out a second look laparoscope in 10 patients. The statistical analysis was carried out by means of the test of hypothesis of Wilcoxon and X2. Inside those results were found that as much the nafarelin as the Goserelin are able to diminish the gonadotropins and estradiol serum levels. Both analogs are effective for the control of the endometriotic lesions. The secondary symptoms are smaller and better supported by the patients using nafarelin. In conclusion as much the nafarelin as the goserelin are appropriate medications for the treatment of the pelvic endometriosis and the election between one or another one can settle down for the comfort of application, secondary effects and cost.
盆腔子宫内膜异位症的医学治疗包括激素疗法,该疗法可直接作用于子宫内膜异位症病灶,或间接抑制子宫内膜增殖,并通过雌激素剥夺诱导萎缩,或产生这些作用的联合效果。本研究的目的是评估两种促性腺激素释放类似物在治疗子宫内膜异位症中的效果。对15例经腹腔镜确诊为子宫内膜异位症的患者进行了研究;将他们随机分为两组,分别给予每12小时200或400微克的醋酸那法瑞林,或每21天3.6毫克的醋酸戈舍瑞林;每四周测定一次促卵泡激素、促黄体生成素、雌二醇和催乳素的血清水平,并报告这些药物的副作用。对10例患者进行了二次腹腔镜检查。采用Wilcoxon检验和X2检验进行统计分析。结果发现,醋酸那法瑞林和醋酸戈舍瑞林均能降低促性腺激素和雌二醇的血清水平。两种类似物对控制子宫内膜异位症病灶均有效。使用醋酸那法瑞林的患者副作用较小,且更能耐受。总之,醋酸那法瑞林和醋酸戈舍瑞林都是治疗盆腔子宫内膜异位症的合适药物,可根据用药便利性、副作用和成本来选择使用其中一种。