Academic Unit of Obstetrics and Gynaecology, Birmingham Women's Hospital, Birmingham, UK.
Am J Obstet Gynecol. 2010 Dec;203(6):547.e1-10. doi: 10.1016/j.ajog.2010.07.037.
To conduct a systematic review and metaanalysis of studies evaluating the regression rate of endometrial hyperplasia with oral progestogens and levonorgestrel-releasing intrauterine system.
Searches were conducted on Medline, Embase, Cochrane Library, and Web of Science, and reference lists of relevant articles were examined. The methodologic index for nonrandomized studies was used for quality assessment. Metaanalysis was performed with random effects model.
There were 24 observational studies (1001 women), of low methodologic quality, evaluating the outcome of regression of endometrial hyperplasia with oral progestogens or levonorgestrel-releasing intrauterine system. Metaanalysis showed that oral progestogens achieved a lower pooled regression rate compared with levonorgestrel-releasing intrauterine system for complex (pooled rate, 66% vs 92%; P < .01) and atypical hyperplasia (pooled rate, 69% vs 90%; P = .03). There was no statistical difference in simple hyperplasia (pooled rate, 89% vs 96%; P = .41).
Oral progestogens appear to induce a lower disease regression rate than Levonorgestrel-releasing intrauterine system in the treatment of endometrial hyperplasia.
系统评价和荟萃分析评估口服孕激素和左炔诺孕酮宫内释放系统治疗子宫内膜增生的消退率的研究。
检索 Medline、Embase、Cochrane 图书馆和 Web of Science，并查阅相关文章的参考文献。使用非随机研究的方法学指数进行质量评估。采用随机效应模型进行荟萃分析。
有 24 项观察性研究（1001 名女性），方法学质量较低，评估了口服孕激素或左炔诺孕酮宫内释放系统治疗子宫内膜增生消退的结果。荟萃分析显示，与左炔诺孕酮宫内释放系统相比，口服孕激素治疗复杂性（合并率，66% vs 92%；P<.01）和非典型性增生（合并率，69% vs 90%；P=.03）的消退率较低。在单纯性增生方面，两者无统计学差异（合并率，89% vs 96%；P=.41）。
在治疗子宫内膜增生方面，口服孕激素似乎比左炔诺孕酮宫内释放系统诱导疾病消退的效果更低。
