Jacobson J, Harris S R, Bullingham R E
Department of Obstetrics & Gynecology, Södertalje Hospital, Sweden.
Acta Obstet Gynecol Scand. 1994 Feb;73(2):144-50. doi: 10.3109/00016349409013417.
Twenty-five women with regular menstruation and laparoscopically confirmed endometriosis received 100 mcg nafarelin intranasally twice daily for six months in an open study. American Fertility Society (AFS) laparoscopic scores pre- and post-treatment, symptom severity, hormonal status, bone density and biochemical indices of bone turnover were studied. Five patients were still menstruating at three months and nafarelin was increased to 400 mcg daily. At the end of treatment, the median serum estradiol was 57 pmol/l and all patients were amenorrhoeic. AFS scores for endometriosis improved significantly in 19/23 (82.6%) patients (p = 0.001). Adhesions were not affected. Symptom severity scores were markedly decreased (p < 0.0001) and remained so six months after the end of treatment. Biochemical indices of bone activation were increased but bone loss was insignificant. During treatment, 23/25 patients reported hot flushes. Nafarelin 200 mcg daily significantly reduced signs and symptoms of endometriosis, although five patients needed a dosage increase before menses stopped. The study suggests that lower doses of nafarelin may be efficacious, although symptomatic changes should be treated with caution due to the open and non-comparative nature of the study.
在一项开放性研究中，25名月经规律且经腹腔镜检查确诊为子宫内膜异位症的女性，每天两次经鼻给予100微克那法瑞林，持续六个月。研究了治疗前后的美国生育协会（AFS）腹腔镜评分、症状严重程度、激素状态、骨密度和骨转换的生化指标。五名患者在三个月时仍有月经，那法瑞林剂量增加至每日400微克。治疗结束时，血清雌二醇中位数为57皮摩尔/升，所有患者均闭经。19/23（82.6%）的患者子宫内膜异位症的AFS评分显著改善（p = 0.001）。粘连未受影响。症状严重程度评分显著降低（p < 0.0001），且在治疗结束后六个月仍保持如此。骨激活的生化指标升高，但骨质流失不明显。治疗期间，23/25的患者报告有潮热。每日200微克那法瑞林可显著减轻子宫内膜异位症的体征和症状，尽管有五名患者在月经停止前需要增加剂量。该研究表明，较低剂量的那法瑞林可能有效，尽管由于该研究的开放性和非对比性，对症状变化应谨慎处理。
