Department of Obstetrics and Gynecology, Etlik Zübeyde Hanim Womens Health Research Hospital, Guvenlik Caddesi, 21/5, Aşagı Ayrancı, 06010, Ankara, Turkey,
Arch Gynecol Obstet. 2014 Jul;290(1):83-6. doi: 10.1007/s00404-014-3161-4. Epub 2014 Feb 1.
To evaluate the treatment of simple endometrial hyperplasia without atypia with different gestagens.
Sixty premenopausal women with histologically documented endometrial hyperplasia without atypia were included in this prospective controlled study. Patients were randomized into two groups: Group I included 30 patients who received lynestrenol (LYN) in a dose of 15 mg/d, while Group II included 30 patients who received micronized progesterone (MP) 200 mg/d for 12 days per cycle for 3 months. Patients were reevaluated with endometrial curettage after treatment. MP and LYN regimens were compared to regression, resolution or persistence rates and metabolic parameters.
After 3 months of treatment in both groups, none of the cases progressed. In LYN group, the rate of resolution was observed to be higher compared to MP group (p = 0.045). LYN was found more effective inducing resolution in patients more than 45 years compared to MP (p = 0.036). When we compare both groups after 3 months of treatment, there was no statistically significant difference in BMI, total cholesterol, HDL, LDL and fibrinogen level between two groups. The rate of patients without any side effects was found to be similar in both groups (p = 0.5).
LYN which is a synthetic progestin ensures better endometrial control compared to MP in simple hyperplasia without atypia in the patients of premenopausal age especially in ages more than 45 years.
评估不同孕激素治疗单纯非典型子宫内膜增生的效果。
本前瞻性对照研究纳入了 60 例经组织学证实的单纯非典型子宫内膜增生的绝经前妇女。患者被随机分为两组：I 组 30 例患者接受炔诺酮（LYN）治疗，剂量为 15mg/d；II 组 30 例患者接受微粒化黄体酮（MP）治疗，剂量为 200mg/d，每周期使用 12 天，共治疗 3 个月。治疗后所有患者均行子宫内膜刮宫术进行评估。比较 MP 和 LYN 方案的缓解、消退或持续率以及代谢参数。
两组患者在治疗 3 个月后均无进展。与 MP 组相比，LYN 组的消退率更高（p=0.045）。LYN 对年龄大于 45 岁的患者的消退效果优于 MP（p=0.036）。治疗 3 个月后，两组间 BMI、总胆固醇、HDL、LDL 和纤维蛋白原水平无统计学差异。两组患者均无明显不良反应（p=0.5）。
在绝经前妇女单纯非典型子宫内膜增生中，与 MP 相比，合成孕激素 LYN 能更好地控制子宫内膜，尤其是在年龄大于 45 岁的患者中。
