Zalányi S, Aedo A R, Johannisson E, Landgren B M, Diczfalusy E
Contraception. 1986 Jun;33(6):567-78. doi: 10.1016/0010-7824(86)90045-4.
Eighteen apparently healthy women with normal menstrual cycles were studied during a control cycle and then during a treatment cycle, in which graded doses (2.5, 5.0 and 10 mg/day) of medroxyprogesterone acetate (MPA) were administered orally on cycle days 7 to 10. In both the control and the treatment cycle peripheral blood was drawn daily for the assay of luteinizing hormone (LH), estradiol (E2) and progesterone (PROG) and an endometrial biopsy was taken on cycle day 11. The lowest dose of MPA (2.5 mg X 4) did not influence the various cycle characteristics. Administration of higher doses (5.0 or 10 mg X 4) resulted in a lengthening of the duration of E2-peak (P less than 0.05), an increase in the area under the E2-peak (P less than 0.05), a decrease in the area under the PROG-curve (P less than 0.05) and a reduction in the height of the LH-peak (P less than 0.05). Furthermore, in 5 of these 12 subjects there was no ovulatory-like PROG-pattern during the cycle in which MPA was administered for 4 days. Morphometric analysis of the endometrial biopsy specimens revealed that the administration of MPA increased the diameter of endometrial glands (P less than 0.01) and the number of vacuolated glandular cells (P less than 0.001), decreased the number of glandular (P less than 0.01) and stromal (P less than 0.05) mitoses and reduced pseudostratification (P less than 0.001). There was no change in the number of endometrial glands and in glandular epithelial height. No leukocytic infiltration was observed. Dating of the biopsies indicated that all control biopsies were proliferative and all, but one (a suppressed proliferation including predecidual reaction), biopsies obtained after MPA administration were early secretory. The most conspicuous effect of MPA administration was a marked increase in subnuclear vacuolation, which could be demonstrated even at the lowest dose (P less than 0.01).
对18名月经周期正常、表面健康的女性进行了研究，先在一个对照周期进行观察，然后在一个治疗周期进行观察。在治疗周期中，于周期第7至10天口服不同剂量（2.5、5.0和10毫克/天）的醋酸甲羟孕酮（MPA）。在对照周期和治疗周期中，每天采集外周血以检测促黄体生成素（LH）、雌二醇（E2）和孕酮（PROG），并在周期第11天进行子宫内膜活检。最低剂量的MPA（2.5毫克×4）对各种周期特征没有影响。给予较高剂量（5.0或10毫克×4）会导致E2峰持续时间延长（P<0.05）、E2峰下面积增加（P<0.05）、PROG曲线下面积减少（P<0.05）以及LH峰高度降低（P<0.05）。此外，在这12名受试者中的5名中，在给予MPA 4天的周期内没有出现类似排卵的PROG模式。对子宫内膜活检标本进行形态计量分析显示，给予MPA会增加子宫内膜腺体直径（P<0.01）和空泡化腺细胞数量（P<0.001），减少腺体（P<0.01）和基质（P<0.05）有丝分裂数量，并减少假复层化（P<0.001）。子宫内膜腺体数量和腺上皮高度没有变化。未观察到白细胞浸润。活检标本的分期表明，所有对照活检均为增殖期，而MPA给药后获得的活检标本，除一份（包括蜕膜前反应的抑制性增殖）外，均为早期分泌期。给予MPA最显著的效果是核下空泡化明显增加，即使在最低剂量时也可观察到（P<0.01）。
