Sporrong T, Samsioe G, Larsen S, Mattsson L A
Department of Obstetrics and Gynecology, University of Göteborg, Sweden.
Maturitas. 1989 Sep;11(3):209-15. doi: 10.1016/0378-5122(89)90212-0.
Previous studies have shown that continuous oral oestrogen-progestogen therapy, which is a relatively new treatment regimen, does not induce endometrial hyperstimulation. However, bleeding disturbances are common during the early months of therapy and in the present study we used both conventional methods of statistical analysis and a stochastic model to describe the bleeding patterns. Four groups of 15 post-menopausal women were given different oral formulations continuously for 1 yr. The oestrogen component in all cases was 2 mg 17 beta-estradiol. The progestogen used was norethisterone acetate at a dose of either 1 mg or 0.5 mg (Groups A and B) or megestrol acetate at a dose of either 5 mg and 2.5 mg (Groups C and D). Each woman kept a daily record of all bleeding episodes, 80% of which occurred during the first 4 mth of therapy. Analysis of variance showed that the high doses of the two progestogens were associated with less spotting and menstrual-like bleeding than the low doses. Stochastic analysis of the bleeding data confirmed that women on the high progestogen doses experienced fewer bleeding episodes than those on the low doses. It also showed that women receiving the high progestogen doses who weighed under 67 kg or had had their last menstruation over 5 yr previously bled less than the other women in the high-dose groups.
先前的研究表明，连续口服雌激素 - 孕激素疗法是一种相对较新的治疗方案，不会引起子宫内膜过度刺激。然而，在治疗的最初几个月中出血紊乱很常见，在本研究中，我们使用了传统的统计分析方法和一个随机模型来描述出血模式。四组，每组15名绝经后妇女连续服用不同的口服制剂1年。所有情况下雌激素成分均为2mg 17β - 雌二醇。使用的孕激素为醋酸炔诺酮，剂量为1mg或0.5mg（A组和B组），或醋酸甲地孕酮，剂量为5mg和2.5mg（C组和D组）。每位女性每天记录所有出血事件，其中80%发生在治疗的前4个月。方差分析表明，与低剂量相比，两种高剂量孕激素与更少的点滴出血和月经样出血相关。对出血数据的随机分析证实，高剂量孕激素组的女性比低剂量组的女性出血事件更少。分析还表明，体重低于67kg或绝经超过5年的接受高剂量孕激素治疗的女性比高剂量组中的其他女性出血更少。
