Wang P H, Yang A H, Yuan C C, Lee W L, Chao H T
Department of Obstetrics and Gynecology, Veterans General Hospital-Taipei, Taiwan, ROC.
Zhonghua Yi Xue Za Zhi (Taipei). 1998 Nov;61(11):625-9.
This study attempted to search for the possible mechanism of regrowth of uterine myoma after cessation of gonadotropin-releasing hormone agonist (GnRHa) therapy.
Five premenopausal women presenting with symptomatic uterine myoma were prospectively studied in this trial. All patients were treated with a subcutaneous injection of goserelin depot 3.6 mg every four weeks for 16 weeks. Clinical examinations as well as hormonal and ultrasound determinations were performed before, during and after treatment to monitor the efficacy of therapy. At the end of the treatment period, all patients underwent myomectomy. The ultrastructural change of the myoma was evaluated postoperatively.
The volume of the uterus decreased 21-57% and the volume of the uterine myoma decreased 21-65% after therapy. There was no significant change in resistance index of the uterine vessels or major vessels supplying the uterine myoma between pretreatment and post-treatment values. The morphologic features of the treated myoma showed marked cellular shrinkage and loss of myofibrillar structure.
There is no significant cellular damage to the cellular structure that contributes to regrowth of treated intramural uterine myoma following cessation of treatment.
本研究试图探寻促性腺激素释放激素激动剂（GnRHa）治疗停止后子宫肌瘤复发的可能机制。
本试验对5例有症状的绝经前子宫肌瘤患者进行了前瞻性研究。所有患者每4周皮下注射戈舍瑞林长效制剂3.6mg，共16周。在治疗前、治疗期间和治疗后进行临床检查以及激素和超声测定，以监测治疗效果。治疗期结束时，所有患者均接受了肌瘤切除术。术后评估肌瘤的超微结构变化。
治疗后子宫体积缩小21%-57%，子宫肌瘤体积缩小21%-65%。治疗前和治疗后子宫血管或供应子宫肌瘤的主要血管的阻力指数无显著变化。治疗后肌瘤的形态学特征表现为细胞明显皱缩和肌原纤维结构丧失。
治疗停止后，治疗过的壁间子宫肌瘤复发并非由于细胞结构受到明显的细胞损伤所致。
