Vercellini P, Fedele L, Maggi R, Vendola N, Bocciolone L, Colombo A
Department of Obstetrics and Gynecology L. Mangiagalli, University of Milano School of Medicine, Italy.
J Reprod Med. 1993 Feb;38(2):127-9.
Twenty-three women with chronic heavy anovulatory uterine bleeding and severe iron-deficiency anemia received six months' treatment with goserelin, a gonadotropin releasing hormone agonist, administered as a monthly subcutaneous depot. After two months of treatment, all patients were amenorrheic and subsequent spotting was reported on only nine occasions. Laboratory results showed the following values: mean hemoglobin before treatment, 7.9 g/dL-13.8 g/dL at six months (+75%); mean hematocrit, 26.3%-41.6% (+58); mean serum iron, 19.8 micrograms/dL-63.3 micrograms/dL (+134%) and mean serum ferritin, 6.2 ng/mL-35.3 ng/mL (+469%). The endometrial hyperplasia observed in 11 subjects showed regression at follow-up suction biopsy. Gonadotropin releasing hormone agonists administered in a depot formulation for a few months in highly selected patients with severe anemia associated with heavy anovulatory uterine bleeding are practical, safe and effective, may avoid blood transfusions and could be used as a first line of treatment.
23名患有慢性重度无排卵性子宫出血和严重缺铁性贫血的女性接受了戈舍瑞林治疗，为期6个月。戈舍瑞林是一种促性腺激素释放激素激动剂，以每月皮下注射长效制剂的形式给药。治疗两个月后，所有患者均闭经，仅9例出现后续点滴出血。实验室检查结果如下：治疗前平均血红蛋白为7.9 g/dL，6个月时为13.8 g/dL（增加75%）；平均血细胞比容为26.3%，6个月时为41.6%（增加58%）；平均血清铁为19.8微克/分升，6个月时为63.3微克/分升（增加134%）；平均血清铁蛋白为6.2纳克/毫升，6个月时为35.3纳克/毫升（增加469%）。11名受试者观察到的子宫内膜增生在随访刮宫活检时出现消退。对于患有与重度无排卵性子宫出血相关的严重贫血的高度选择患者，以长效制剂形式给予促性腺激素释放激素激动剂数月是实用且安全有效的，可避免输血，可作为一线治疗方法。
