Candiani G B, Vercellini P, Fedele L, Arcaini L, Bianchi S, Candiani M
1st Department of Obstetrics and Gynecology, University of Milan School of Medicine, Italy.
Acta Obstet Gynecol Scand. 1990;69(5):413-5. doi: 10.3109/00016349009013304.
Menorrhagia is the most frequent symptom in women with leiomyomata uteri. We induced transient hypoestrogenism with a gonadotropin-releasing hormone agonist, goserelin (Zoladex, I.C.I.), in a depot formulation, to resolve severe anemia in 16 women with uterine myomas. Subcutaneous administration of goserelin 3.6 mg was repeated every 28 days for 6 months. Thirteen patients became amenorrheic in 5 weeks and 3 reported scanty bleeding. Estradiol fell to postmenopausal levels after one month's treatment with hormonal surges on only three occasions. Uterine volume decreased by 49% after 3 months' treatment but subsequent reduction was not achieved. Mean hemoglobin rose from 7.4 g/dl pretreatment to 13.2 g/dl at 3 months (+78.3%) and mean hematocrit from 26.1% to 39.8% (+52.4%) without any further improvement. Serum ferritin increased constantly during the 6 months. Goserelin depot therapy in severely anemic patients with leiomyomas and menorrhagia is practical, safe and may avoid the need for preoperative transfusion.
月经过多是子宫肌瘤女性最常见的症状。我们使用长效促性腺激素释放激素激动剂戈舍瑞林（Zoladex，ICI公司生产）诱导短暂性低雌激素血症，以治疗16例子宫肌瘤女性的严重贫血。每28天皮下注射3.6 mg戈舍瑞林，持续6个月。13例患者在5周内闭经，3例报告有少量出血。治疗1个月后，雌二醇降至绝经后水平，仅出现3次激素波动。治疗3个月后子宫体积减少49%，但随后未进一步缩小。平均血红蛋白从治疗前的7.4 g/dl升至3个月时的13.2 g/dl（+78.3%），平均血细胞比容从26.1%升至39.8%（+52.4%），且未再有进一步改善。血清铁蛋白在6个月内持续升高。戈舍瑞林长效疗法对于严重贫血的子宫肌瘤伴月经过多患者是可行、安全的，且可能避免术前输血。
