醋酸乌利司他治疗3个月后子宫肌瘤患者的结局
Outcome of patients with uterine fibroids after 3-month ulipristal acetate therapy.
作者信息
Brun Jean-Luc, Rajaonarison José, Froeliger Alizée, Monseau-Thiburce Anne-Coline, Randriamboavonjy Rado, Vogler Andrej
机构信息
Department of Obstetrics and Gynecology, University Hospital of Bordeaux, Bordeaux, France.
Department of Imaging, University Hospital of Bordeaux, Bordeaux, France.
出版信息
Eur J Obstet Gynecol Reprod Biol. 2018 Mar;222:13-18. doi: 10.1016/j.ejogrb.2017.12.033. Epub 2017 Dec 19.
OBJECTIVES
To determine the proportion and the characteristics of patients who did or did not respond after 3 months of ulipristal acetate (UPA) therapy.
STUDY DESIGN
In this retrospective cohort study conducted in the University Hospital of Bordeaux (France) and University Medical Center Ljubljana (Slovenia), symptomatic non-menopausal patients with fibroids that qualified for surgery were pretreated by 3 months of oral UPA 5 mg/day. Clinical success was defined by normalization of the bleeding score, and/or regression of pelvic pain, and/or abdominal distension. Imaging success was defined by reduction in fibroid volume ≥ 25%.
RESULTS
The clinical and imaging success rates were 54/66 (82%) and 39/66 (59%) respectively. The absence of previous pregnancy (p = 0.004) and the size of the dominant fibroid ≥ 80 mm (p = 0.004) were independent factors associated with clinical failure. Age <35 years (p = 0.02) was the only independent factor associated with imaging failure.
CONCLUSION
Young women developing fibroids and/or women with large fibroids may be resistant to ulipristal acetate therapy.
目的
确定醋酸乌利司他（UPA）治疗3个月后有反应和无反应患者的比例及特征。
研究设计
在法国波尔多大学医院和斯洛文尼亚卢布尔雅那大学医学中心进行的这项回顾性队列研究中，符合手术条件的有症状非绝经期子宫肌瘤患者接受为期3个月、每日口服5毫克UPA的预处理。临床成功定义为出血评分正常化，和/或盆腔疼痛消退，和/或腹胀缓解。影像学成功定义为肌瘤体积缩小≥25%。
结果
临床成功率和影像学成功率分别为54/66（82%）和39/66（59%）。既往未孕（p = 0.004）和最大肌瘤直径≥80毫米（p = 0.004）是与临床失败相关的独立因素。年龄<35岁（p = 0.02）是与影像学失败相关的唯一独立因素。
结论
患子宫肌瘤的年轻女性和/或肌瘤较大的女性可能对醋酸乌利司他治疗耐药。
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