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长效曲普瑞林注射剂延长给药间隔方案对子宫内膜异位症患者激素水平的影响:前瞻性观察研究

Effects of an extended-interval dosing regimen of triptorelin depot on the hormonal profile of patients with endometriosis: prospective observational study.

作者信息

Tse C Y, Chow A M, Chan S C

机构信息

Department of Obstetrics and Gynaecology, Queen Elizabeth Hospital, 30 Gascoigne Road, Kowloon, Hong Kong.

出版信息

Hong Kong Med J. 2000 Sep;6(3):260-4.

Abstract

OBJECTIVE

To evaluate the suppression of pituitary gonadotrophins and ovarian steroid hormone with the administration of triptorelin depot at 6-weekly intervals.

DESIGN

Prospective observational study.

SETTING

Obstetrics and gynaecology department of a public hospital, Hong Kong.

PATIENTS

Consecutive patients with endometriosis, as diagnosed by laparoscopy or laparotomy from June 1998 through February 1999.

INTERVENTION

Administration of four doses of triptorelin depot 3.75 mg either subcutaneously or intramuscularly every 6 weeks (21 patients), or conventional 4-weekly six-dose regimen (five patients).

MAIN OUTCOME MEASURES

Serum levels of 17-beta-oestradiol, luteinizing hormone, and follicle-stimulating hormone; and pelvic pain symptoms.

RESULTS

For the patients receiving the extended-interval dosing regimen of triptorelin, the levels of oestradiol and luteinizing hormone, and the pain score were significantly reduced throughout the treatment period and up to 10 weeks after the injection of the last dose. The level of follicle-stimulating hormone increased slowly but was still significantly lower than pretreatment levels. The hormonal profile was similar to that of patients receiving the conventional regimen.

CONCLUSION

The use of the extended-interval dosing regimen of triptorelin depot results in a consistent hypo-oestrogenised state, which is similar to that achieved by the conventional regimen and which would be considered satisfactory for the medical treatment of pelvic endometriosis. The new regimen thus reduces the cost of treatment without compromising the effect on hormonal suppression.

摘要

目的

评估每6周注射一次曲普瑞林长效注射剂对垂体促性腺激素和卵巢甾体激素的抑制作用。

设计

前瞻性观察研究。

地点

香港一家公立医院的妇产科。

患者

1998年6月至1999年2月间经腹腔镜检查或剖腹手术确诊的连续子宫内膜异位症患者。

干预措施

每6周皮下或肌肉注射4剂3.75mg曲普瑞林长效注射剂(21例患者),或采用传统的每4周6剂给药方案(5例患者)。

主要观察指标

血清17-β-雌二醇、促黄体生成素和促卵泡生成素水平;以及盆腔疼痛症状。

结果

接受曲普瑞林延长间隔给药方案的患者,在整个治疗期间以及最后一剂注射后长达10周内,雌二醇和促黄体生成素水平以及疼痛评分均显著降低。促卵泡生成素水平缓慢升高,但仍显著低于治疗前水平。激素水平变化与接受传统给药方案的患者相似。

结论

采用曲普瑞林长效注射剂延长间隔给药方案可导致持续的低雌激素状态,这与传统给药方案相似,对于盆腔子宫内膜异位症的药物治疗而言可认为是令人满意的。因此,新方案在不影响激素抑制效果的情况下降低了治疗成本。

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