De Leo V, Morgante G, Lanzetta D, D'Antona D, Bertieri R S
Department of Obstetrics and Gynaecology, University of Siena, Italy.
Hum Reprod. 1997 Feb;12(2):357-60. doi: 10.1093/humrep/12.2.357.
We report the results of administration of danazol after suspension of gonadotrophin-releasing hormone analogue (GnRHa) therapy for uterine myomas. A total of 21 women with uterine myomas was treated with 100 mg danazol for 6 months after GnRHa therapy. Uterine volume and endocrine status were monitored monthly by ultrasound and assay of plasma gonadotrophins, oestradiol and progesterone. The results show a rebound of uterine volume about 30% less than in controls at the end of danazol therapy. Menstrual cyclicity returned after 65 +/- 3 days in 16 subjects and five patients remained amenorrhoeic. Hormone assays confirmed renewed ovarian function in the women whose menstrual periods returned. Bone mineral content was substantially reduced during GnRHa treatment but improved significantly during danazol therapy even in the women who remained amenorrhoeic. These results show the utility of danazol in prolonging the therapeutic effects of GnRHa. The mechanism by which danazol inhibits rebound of uterine volume may be due to its antiprogesterone effects on uterine myomas.
我们报告了在子宫肌瘤患者中，促性腺激素释放激素类似物（GnRHa）治疗暂停后使用达那唑的结果。共有21例子宫肌瘤患者在GnRHa治疗后接受了100mg达那唑治疗6个月。每月通过超声检查以及血浆促性腺激素、雌二醇和孕酮测定来监测子宫体积和内分泌状态。结果显示，在达那唑治疗结束时，子宫体积的反弹比对照组少约30%。16名受试者在65±3天后月经周期恢复，5名患者仍闭经。激素检测证实月经恢复的女性卵巢功能恢复。GnRHa治疗期间骨矿物质含量大幅降低，但即使在仍闭经的女性中，达那唑治疗期间骨矿物质含量也显著改善。这些结果表明达那唑在延长GnRHa治疗效果方面的效用。达那唑抑制子宫体积反弹的机制可能是其对子宫肌瘤的抗孕激素作用。
