Delzanno G, Paoletti R, Gaudiano L, Bertinetti G, Ventrella C A, Dell'Elce C
Divisione di Ginecologia e Ostetricia, Regione Piemonte, USSL n. 56, Ospedale San Biagio di Domodossola Novara.
Minerva Ginecol. 1994 Apr;46(4):179-82.
The authors consider postmenopausal replacement oestrogen therapy to be appropriate provided that in non-hysterectomised women it is associated with a progestin compound. For this purpose they studied the endometrial changes in women treated randomly with dihydrogesterone and medroxyprogesterone acetate. Having performed a pre-treatment biopsy, in order to include only those cases with hypotrophic endometrium or with residual proliferative activity, cyclical treatment was commenced with transdermic estradiol and dihydrogesterone or medroxyprogesterone acetate. An endometrial follow-up was performed after 6 months to control the maturation of the endometrium which was free from atypical transformations although medroxyprogesterone acetate was preferable due to its effects on the metabolism in general and because it allowed a higher percentage of conversion into secreting endometrium without evolving towards hyperplasia.
作者认为，对于未行子宫切除术的女性，绝经后雌激素替代疗法若与孕激素复合使用则是合适的。为此，他们研究了随机接受双氢孕酮和醋酸甲羟孕酮治疗的女性的子宫内膜变化。在进行预处理活检后，为了仅纳入那些子宫内膜萎缩或有残余增殖活性的病例，开始采用经皮雌二醇与双氢孕酮或醋酸甲羟孕酮进行周期性治疗。6个月后进行子宫内膜随访，以控制子宫内膜的成熟情况，结果显示子宫内膜无非典型性改变，不过由于醋酸甲羟孕酮对整体代谢的影响，且它能使更高比例的子宫内膜转化为分泌期内膜而不发展为增生，所以醋酸甲羟孕酮更为可取。
