Matsushima Takashi, Akira Shigeo, Fukami Takehiko, Yoneyama Koichi, Takeshita Toshiyuki
Department of Obstetrics and Gynecology, Nippon Medical School Musashikosugi Hospital, Kawasaki, Japan.
Department of Obstetrics and Gynecology, Nippon Medical School, Tokyo, Japan.
Gynecol Minim Invasive Ther. 2018 Jul-Sep;7(3):119-123. doi: 10.4103/GMIT.GMIT_35_18. Epub 2018 Aug 23.
The aim of this study is to evaluate the efficacy of hormonal therapies for inhibiting an increase in uterine volume in patients with adenomyosis.
This was retrospective cohort study.
This study was conducted at Nippon Medical School Musashikosugi Hospital.
A total of 28 women diagnosed with adenomyosis using magnetic resonance imaging.
After providing informed consent, patients were treated with gonadotropin-releasing hormone agonist (GnRHa group), a low-dose estrogen and progestin combination (LEP group), or dienogest (DNG group) for ≥16 weeks. Uterine volume was assessed using the formula for an ovoid; uterine volumes before and after 16 weeks of treatment were compared. A <5% increase in uterine volume at 16 weeks was considered to reflect inhibition of uterine volume increase and efficacy of the medication. We compared the efficacy rate among the groups.
In the GnRHa group, a significant reduction in uterine volume was noted, from 307.4 ± 230.1 to 177.9 ± 142.1 cm ( < 0.001). In the LEP and the DNG groups, there was no significant change (LEP: 226.7 ± 116.6 cm pre-treatment and 230.5 ± 128.6 cm post-treatment, = 0.85; DNG: 232.6 ± 117.8 cm pre-treatment and 262.1 ± 136.8 cm post-treatment, = 0.37). The number of responders (efficacy rate) in the GnRHa group, LEP group, and DNG group was 25/26 (96.2%), 7/15 (46.7%), and 6/11 (54.5%), respectively. The efficacy rate of GnRHa therapy was significantly higher than that of LEP or DNG therapy ( < 0.001 and = 0.005, respectively).
We conclude that the efficacy of GnRHa in reducing uterine volume should be considered when prescribing hormone therapy for adenomyosis.
本研究旨在评估激素疗法对抑制子宫腺肌病患者子宫体积增加的疗效。
这是一项回顾性队列研究。
本研究在日本医科大学武藏小杉医院进行。
共有28名经磁共振成像诊断为子宫腺肌病的女性。
在获得知情同意后，患者接受促性腺激素释放激素激动剂治疗（GnRHa组）、低剂量雌激素和孕激素联合治疗（LEP组）或地诺孕素治疗（DNG组）≥16周。使用椭圆形公式评估子宫体积；比较治疗16周前后的子宫体积。治疗16周时子宫体积增加<5%被认为反映了子宫体积增加的抑制和药物疗效。我们比较了各组的有效率。
GnRHa组子宫体积显著减小，从307.4±230.1 cm降至177.9±142.1 cm（<0.001）。LEP组和DNG组无显著变化（LEP组：治疗前226.7±116.6 cm，治疗后230.5±128.6 cm，P = 0.85；DNG组：治疗前232.6±117.8 cm，治疗后262.1±136.8 cm，P = 0.
