Venturini P L, Bertolini S, Brunenghi M C, Daga A, Fasce V, Marcenaro A, Cimato M, De Cecco L
Department of Obstetrics and Gynaecology, University of Genoa, Italy.
Fertil Steril. 1989 Oct;52(4):589-95. doi: 10.1016/s0015-0282(16)60969-x.
The effect of oral gestrinone, 2.5 mg twice weekly for 6 months, was studied in 11 women with mild or moderate endometriosis laparoscopically confirmed. The mean laparoscopic score decreased from 17.18 to 9.09 (P greater than 0.005). Painful symptoms were relieved in all patients within 2 months from start of therapy. Gonadotropins, prolactin (PRL) 17 beta-estradiol (17 beta-E2), estrone (E1), progesterone (P), androstenedione (A), and dehydroepiandrosterone sulfate (DHEA-S) remained in the follicular phase range. Total testosterone (TT) and sex hormone-binding globulin (SHBG) decreased, whereas free testosterone (FT) slightly increased. Metabolic studies showed a decrease of total triglycerides, very low-density lipoprotein (VLDL) triglycerides, and high-density lipoprotein (HDL) and VLDL cholesterol, parallel to the decrease of associated apoproteins. Low-density lipoprotein cholesterol and apoprotein B increased during therapy. The results suggest that gestrinone possesses antiestrogenic, androgenic, and progestigenic effects at therapeutic dosages both by acting on central and peripheral steroid receptors. For its efficacy and good tolerance, gestrinone may be considered an option for treating endometriosis.
对11例经腹腔镜确诊为轻度或中度子宫内膜异位症的女性患者，研究了口服孕三烯酮（每周两次，每次2.5mg，共6个月）的疗效。腹腔镜评分均值从17.18降至9.09（P＞0.005）。所有患者在治疗开始后2个月内疼痛症状均得到缓解。促性腺激素、催乳素（PRL）、17β-雌二醇（17β-E2）、雌酮（E1）、孕酮（P）、雄烯二酮（A）及硫酸脱氢表雄酮（DHEA-S）均维持在卵泡期水平。总睾酮（TT）和性激素结合球蛋白（SHBG）降低，而游离睾酮（FT）略有升高。代谢研究显示，总甘油三酯、极低密度脂蛋白（VLDL）甘油三酯、高密度脂蛋白（HDL）及VLDL胆固醇均降低，同时相关载脂蛋白也减少。治疗期间低密度脂蛋白胆固醇和载脂蛋白B升高。结果表明，孕三烯酮在治疗剂量下通过作用于中枢和外周甾体受体，具有抗雌激素、雄激素及孕激素样作用。因其疗效和良好的耐受性，孕三烯酮可被视为治疗子宫内膜异位症的一种选择。
