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醋酸乌利司他治疗有症状子宫肌瘤的管理:一项回顾性、多中心和全国性研究。

Management of symptomatic uterine fibroids with ulipristal acetate: A retrospective, multicentric and nationwide study.

机构信息

Gynaecology Service, Coimbra Hospital and University Centre, Coimbra, Portugal.

Gynaecology and Obstetrics Service, Algarve Hospital and University Centre, Portimão, Portugal.

出版信息

J Gynecol Obstet Hum Reprod. 2020 Oct;49(8):101862. doi: 10.1016/j.jogoh.2020.101862. Epub 2020 Jul 8.

Abstract

OBJECTIVE

To evaluate symptomatic uterine fibroid outcomes following at least one course of ulipristal acetate (UPA) 5 mg/day therapy in the hospital setting, during the year 2017.

STUDY DESIGN

A retrospective and descriptive analysis involving women with symptomatic fibroids was conducted in 15 hospital centers in Portugal in 2017 to assess fibroid size, bleeding control and hemoglobin levels following at least one course of UPA 5 mg/day. Secondary outcomes were the reasons for the treatment, type of surgery, fibroid classification, patient satisfaction with the treatment, and adverse events.

RESULTS

Five-hundred and twenty-six patients were enrolled in this survey, and 93 % of the women completed, at least, 1 treatment course with UPA. Uterine bleeding control was achieved in 81 % of the cases. A significant increase (p < 0.001) in hemoglobin levels and a reduction (p < 0.001) in uterine fibroid size was observed after treatment, with a median reduction of 24 % from the baseline. Forty-seven percent of the patients underwent subsequent surgery and there were no serious adverse events reported in this multicentric nationwide study.

CONCLUSIONS

So far, this is the largest case series reporting on symptomatic uterine fibroid outcomes after UPA therapy in Portugal. Our data are in line with published literature and confirm favorable outcomes after UPA therapy for women of childbearing age and premenopausal.

摘要

目的

评估 2017 年至少接受过一次乌利司他 5mg/天院内治疗的症状性子宫肌瘤患者的结局。

研究设计

2017 年,葡萄牙 15 家医院中心对患有症状性子宫肌瘤的女性进行了回顾性和描述性分析,以评估至少接受过一次乌利司他 5mg/天治疗后子宫肌瘤的大小、出血控制和血红蛋白水平。次要结局包括治疗原因、手术类型、子宫肌瘤分类、患者对治疗的满意度和不良事件。

结果

本研究共纳入 526 例患者,其中 93%的女性至少完成了 1 个疗程的乌利司他治疗。81%的病例出血得到控制。治疗后血红蛋白水平显著升高(p<0.001),子宫肌瘤体积缩小(p<0.001),中位数缩小 24%。47%的患者随后接受了手术,这项多中心全国性研究未报告严重不良事件。

结论

迄今为止,这是葡萄牙报道乌利司他治疗症状性子宫肌瘤结局的最大病例系列研究。我们的数据与已发表的文献一致,证实了乌利司他治疗育龄期和绝经前妇女的良好结局。

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