子宫肌瘤的当前管理：随着选择性孕激素受体调节剂的出现，药物治疗的地位
Current management of myomas: the place of medical therapy with the advent of selective progesterone receptor modulators.
作者信息
Donnez Jacques, Arriagada Pablo, Donnez Olivier, Dolmans Marie-Madeleine
机构信息
aSRI, Société de Recherche pour l'Infertilité, Brussels, Belgium bPregLem SA, Plan-les-ouates, Switzerland cPôle de Gynécologie, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Woluwe-Saint-Lambert, Brussels, Belgium dPolyclinique Urbain V, Avignon, France eCliniques Universitaires Saint-Luc, Service de Gynécologie, Bruxelles, Belgium.
出版信息
Curr Opin Obstet Gynecol. 2015 Dec;27(6):422-31. doi: 10.1097/GCO.0000000000000229.
PURPOSE OF REVIEW
To review the current management of myomas with the advent of selective progesterone receptor modulators.
RECENT FINDINGS
Selective progesterone receptor modulators have proved effective and recent publications on the use of ulipristal acetate (UPA) have analyzed the performance of long-term intermittent utilization of 10 mg UPA given in repeated courses of 3 months. This long-term intermittent therapy maximizes the efficacy of UPA. Indeed, control of bleeding is achieved sooner after each course. With each subsequent course, a statistically greater number of patients show a fibroid volume reduction of more than 50%.
SUMMARY
The choice of therapy is influenced by different factors, such as the severity of symptoms, tumor characteristics, age, and wish to preserve the uterus (and fertility). Use of UPA will undoubtedly modify the surgical approach.
综述目的
随着选择性孕激素受体调节剂的出现，回顾子宫肌瘤的当前管理方法。
最新发现
选择性孕激素受体调节剂已被证明有效，最近关于醋酸乌利司他（UPA）使用的出版物分析了在3个月的重复疗程中给予10mg UPA长期间歇性使用的效果。这种长期间歇性治疗可使UPA的疗效最大化。事实上，每次疗程后出血控制更快。随着后续每个疗程，在统计学上有更多患者的肌瘤体积缩小超过50%。
总结
治疗方法的选择受不同因素影响，如症状严重程度、肿瘤特征、年龄以及保留子宫（和生育能力）的意愿。UPA的使用无疑将改变手术方式。
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