Lumbiganon P, Rugpao S, Phandhu-fung S, Laopaiboon M, Vudhikamraksa N, Werawatakul Y
Department of Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen University, Thailand.
Br J Obstet Gynaecol. 1996 Sep;103(9):909-14. doi: 10.1111/j.1471-0528.1996.tb09911.x.
To assess the protective effect of depot-medroxyprogesterone acetate (DMPA) on uterine leiomyomas. DMPA has been widely used in Thailand for many years; uterine leiomyomas is the most common female tumour.
A multicentre hospital-based case--control study.
University and regional hospitals.
Cases were all newly diagnosed patients with pathologically proven diagnosis of uterine leiomyomas, who were admitted to eight hospitals in three regions of Thailand from January 1991 to June 1993. Three controls matched with cases by sex, age within five years and date of admission within three months were recruited.
Information on socio-demographic factors, personal and family history, current disease, reproductive and contraceptive history was collected from cases and controls by interview.
There were 910 cases and 2709 controls. After univariate and unconditional multiple logistic regression analysis, risk factors associated positively with uterine leiomyomas are tubal ligation, family history of uterine leiomyomas, higher education, obesity and abortion. In contrast, DMPA, use of oral contraceptives, higher parity and smoking are associated with a lower relative risk suggesting that they have a protective effect against uterine leiomyomas. This causative relation is further strengthened by the strong duration-response relation between DMPA and uterine leiomyomas. This protection may persist for more than 10 years after the last dose.
We have demonstrated a strong, duration dependent protective effect of DMPA against uterine leiomyomas.
评估醋酸甲羟孕酮长效避孕针（DMPA）对子宫平滑肌瘤的保护作用。DMPA在泰国已广泛使用多年；子宫平滑肌瘤是最常见的女性肿瘤。
一项基于医院的多中心病例对照研究。
大学医院和地区医院。
病例均为新诊断的经病理证实为子宫平滑肌瘤的患者，于1991年1月至1993年6月入住泰国三个地区的八家医院。招募了三名与病例在性别、年龄相差五岁以内以及入院日期在三个月内相匹配的对照。
通过访谈从病例和对照中收集有关社会人口学因素、个人和家族病史、当前疾病、生殖和避孕史的信息。
有910例病例和2709名对照。经过单因素和无条件多因素逻辑回归分析，与子宫平滑肌瘤呈正相关的危险因素有输卵管结扎、子宫平滑肌瘤家族史、高等教育、肥胖和流产。相比之下，DMPA、口服避孕药的使用、较高的产次和吸烟与较低的相对风险相关，表明它们对子宫平滑肌瘤有保护作用。DMPA与子宫平滑肌瘤之间强烈的剂量反应关系进一步加强了这种因果关系。这种保护作用可能在最后一剂后持续超过10年。
我们已证明DMPA对子宫平滑肌瘤有强大的、持续时间依赖的保护作用。
