Bouchard Philippe, Chabbert-Buffet Nathalie
University Pierre et Marie Curie, Hospital saint Antoine, 75012, Paris, France; Department of Ob Gyn, Hospital Foch, 92150, Suresnes, France.
University Pierre et Marie Curie, Hospital saint Antoine, 75012, Paris, France; Department of Ob Gyn, Hospital Tenon, 75020, Paris, France.
Best Pract Res Clin Obstet Gynaecol. 2017 Apr;40:105-110. doi: 10.1016/j.bpobgyn.2016.12.002. Epub 2016 Dec 18.
Progesterone receptor modulators (PRM) or selective progesterone receptor modulators have two remarkable effects in treated women. They considerably suppress endometrial bleeding by incompletely understood mechanisms, and when administered in women with symptomatic fibroids, they produce a significant and potentially long-term decrease in fibroid volume. The crucial advantage of this therapy lies with the absence of suppression of ovarian oestrogen secretion, which is in contrast to GnRH agonists. Long-term treatments have proven to be useful, especially in women approaching the menopausal transition. However, their use is associated with endometrial modifications called PRM-associated endometrial changes (PAECs). Although these abnormalities are now described as benign, the treatment is best administered in an intermittent manner where the PAECs rapidly disappear, while the beneficial effects on fibroid size and uterine bleeding are maintained or even improved in the long term.
孕激素受体调节剂（PRM）或选择性孕激素受体调节剂对接受治疗的女性有两个显著作用。它们通过尚不完全清楚的机制显著抑制子宫内膜出血，并且在有症状的子宫肌瘤女性中使用时，会使肌瘤体积显著且可能长期减小。这种疗法的关键优势在于不会抑制卵巢雌激素分泌，这与促性腺激素释放激素激动剂形成对比。长期治疗已被证明是有效的，尤其是对于接近绝经过渡期的女性。然而，它们的使用与称为PRM相关子宫内膜变化（PAECs）的子宫内膜改变有关。尽管现在将这些异常描述为良性，但最好以间歇方式给药，这样PAECs会迅速消失，而对肌瘤大小和子宫出血的有益作用在长期内得以维持甚至改善。
