Department of Obstetrics and Gynecology, Ain Shams University, Cairo, Egypt.
Reprod Sci. 2013 Jan;20(1):45-50. doi: 10.1177/1933719112459243.
To evaluate the efficacy of 3 progestin treatment regimens in the management of simple endometrial hyperplasia without cytological atypia in premenopausal women.
Prospective randomized comparative study. The study included 90 premenopausal women with histological diagnosis of simple endometrial hyperplasia (EH) without atypia, during the period from January 2010 to March 2012, at TAIBA Hospital in Kuwait. Patients were randomly allocated to 3 groups of 30 patients each receiving medroxyprogesterone acetate (MPA, 10 mg/d; group I), norethisterone (NET, 15 mg/d; group II) for 10 days per cycle, or insertion of levonorgestrel-releasing intrauterine system (LNG-IUS; group III). Patients were reevaluated after 3 months of treatment. Patients with regression and persistence were offered the same medication they were using for another 3 months. The primary outcome of the study was the proportion of patients requiring further treatment for another 3 months.
Patients in the LNG-IUS group showed the highest resolution rate (66.67%). Patients in MPA group had a resolution rate of 36.66% where the resolution rate was 40% in patients of NET group. The patients having LNG-IUS showed a regression rate of 33.3%, whereas patients receiving MPA and NET showed a regression rate of 60% and 56.67%, respectively. There was a statistically significant difference between the 3 groups regarding the proportion of patients requiring further treatment for another 3 months (χ(2) = 6.501; P = .0387).
The LNG-IUS appears to represent an effective superior convenient treatment option for simple EH without atypia.
评估 3 种孕激素治疗方案在管理无细胞学不典型的绝经前妇女单纯性子宫内膜增生症中的疗效。
前瞻性随机对照研究。该研究纳入了 2010 年 1 月至 2012 年 3 月期间科威特 TAIBA 医院 90 例经组织学诊断为单纯性子宫内膜增生症（EH）且无不典型的绝经前妇女。患者随机分为 3 组，每组 30 例，分别接受醋酸甲羟孕酮（MPA，10 mg/d；I 组）、炔诺酮（NET，15 mg/d；II 组），每周期 10 天，或放置左炔诺孕酮释放宫内节育系统（LNG-IUS；III 组）。治疗 3 个月后对患者进行重新评估。对于消退和持续存在的患者，提供与之前相同的药物进行另外 3 个月的治疗。该研究的主要结局是需要进一步治疗的患者比例。
LNG-IUS 组患者的缓解率最高（66.67%）。MPA 组患者的缓解率为 36.66%，NET 组患者的缓解率为 40%。LNG-IUS 组患者的消退率为 33.3%，而 MPA 和 NET 组患者的消退率分别为 60%和 56.67%。3 组患者需要进一步治疗的比例存在统计学差异（χ(2) = 6.501；P =.0387）。
LNG-IUS 似乎是一种有效且方便的治疗无细胞学不典型单纯性 EH 的选择。
