Choktanasiri W, Boonkasemsanti W, Sittisomwong T, Kunathikom S, Suksompong S, Udomsubpayakul U, Rojanasakul A
Department of Obstetrics and Gynecology, Ramathibodi Hospital, Bangkok, Thailand.
Int J Gynaecol Obstet. 1996 Sep;54(3):237-43. doi: 10.1016/0020-7292(96)02698-7.
To evaluate the efficacy and adverse effects of monthly triptorelin injection for the treatment of endometriosis.
A multicenter clinical trial including 45 women with endometriosis, treated with triptorelin 3.75 mg i.m. every 4 weeks in six consecutive doses. The main outcome measures were symptom relief, reduction according to revised American Fertility Society (rAFS) scores, reduction in size of ovarian endometrioma, effects on hormone and lipid profiles, changes in bone mineral density (BMD), adverse effects, and return of menstruation. Data were analyzed using repeated measures analysis of variance and paired t-tests.
Pain-related symptoms decreased in all cases after 8 weeks of treatment. Laparoscopic assessment revealed a reduction in rAFS scores in 21 out of 25 cases (mean pretreatment scores 43.44 +/- 5.75 vs. post-treatment scores 22.30 +/- 3.40, P < 0.001). The size of ovarian endometrioma decreased in eight of nine women but none disappeared. Serum luteinizing hormone, follicle-stimulating hormone and estradiol levels were effectively suppressed during treatment. A slight increase in cholesterol and triglyceride levels was observed but all values were within normal limits. After 24 weeks of treatment there was a slight decrease in BMD of total body, lumbar vertebrae and femoral neck but not radius. The main adverse effects included hot flushes, night sweating, vaginal dryness, headache, dizziness and nausea Menstruation returned 83.76 +/- 2.91 days after the last injection of triptorelin.
Long-acting triptorelin is efficacious in the treatment of endometriosis and has tolerable side effects.
评估每月注射曲普瑞林治疗子宫内膜异位症的疗效及不良反应。
一项多中心临床试验，纳入45例子宫内膜异位症女性患者，每4周肌肉注射3.75 mg曲普瑞林，连续注射6剂。主要观察指标包括症状缓解情况、根据修订的美国生育协会（rAFS）评分的降低情况、卵巢子宫内膜异位囊肿大小的减小情况、对激素和血脂水平的影响、骨密度（BMD）的变化、不良反应以及月经恢复情况。采用重复测量方差分析和配对t检验进行数据分析。
治疗8周后所有病例与疼痛相关的症状均减轻。腹腔镜评估显示，25例中有21例rAFS评分降低（治疗前平均评分为43.44±5.75，治疗后为22.30±3.40，P<0.001）。9例女性中有8例卵巢子宫内膜异位囊肿大小减小，但无囊肿消失。治疗期间血清促黄体生成素、促卵泡生成素和雌二醇水平得到有效抑制。观察到胆固醇和甘油三酯水平略有升高，但所有值均在正常范围内。治疗24周后，全身、腰椎和股骨颈的骨密度略有下降，但桡骨未下降。主要不良反应包括潮热、盗汗、阴道干燥、头痛、头晕和恶心。月经在最后一次注射曲普瑞林后83.76±2.91天恢复。
长效曲普瑞林治疗子宫内膜异位症有效，且副作用可耐受。
