Saarikoski S, Yliskoski M, Penttilä I
Department of Obstetrics and Gynaecology, University Central Hospital of Kuopio, Finland.
Maturitas. 1990 Jun;12(2):89-97. doi: 10.1016/0378-5122(90)90086-l.
Sequential treatment with norethisterone (NET) or natural micronized progesterone (NMP) was administered randomly to 80 consecutive patients attending our clinic because of cycle disorders. The endometrial morphology indicated a need for progestogen therapy in all cases and the endometrium was hyperplastic in half of the women before therapy. Hyperplastic changes disappeared during the first three cycles of treatment with both NET and NMP, the duration of treatment being 6 months. However, the carry-over effect of both progestogens was short: three months after treatment was discontinued a proliferative or hyperplastic endometrial pattern recurred in 24% and 10% of cases, respectively. Whereas NET decreased oestradiol, follicle-stimulating hormone, luteinizing hormone and sex-hormone-binding globulin levels (P less than 0.001) no changes were seen during NMP treatment. High-density-lipoprotein cholesterol and triglyceride levels were also lowered by NET (P less than 0.001-0.02) and there was a slight decrease in phospholipids. NMP treatment induced no changes in serum lipid values and thus offers an alternative form of therapy in premenopausal bleeding disorders.
因月经周期紊乱前来我院门诊的80例连续患者被随机给予炔诺酮（NET）或天然微粒化孕酮（NMP）序贯治疗。所有病例的子宫内膜形态均显示需要进行孕激素治疗，且治疗前一半女性的子宫内膜呈增生状态。在NET和NMP治疗的前三个周期中，增生性改变均消失，治疗持续时间为6个月。然而，两种孕激素的持续效应均较短：停药三个月后，分别有24%和10%的病例出现增殖性或增生性子宫内膜模式复发。NET可降低雌二醇、卵泡刺激素、黄体生成素和性激素结合球蛋白水平（P<0.001），而NMP治疗期间未见变化。NET还降低了高密度脂蛋白胆固醇和甘油三酯水平（P<0.001-0.02），磷脂略有下降。NMP治疗未引起血清脂质值的变化，因此为绝经前出血性疾病提供了另一种治疗方式。
