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目的比较促性腺激素释放激素激动剂(GnRH-α)联合小剂量替勃龙短期治疗对子宫内膜异位症患者内分泌水平及骨质丢失的影响。方法选择2015年3月-2016年3月于新疆医科大学第一附属医院妇科一病区行腹腔镜保守性手术,病理结果证实为子宫内膜异位症,术后使用GnRH-α治疗的患者150例,随机分为单用GnRH-α组(A组)和反加组(B组)。B组自第1次注射GnRH-α同时口服替勃龙1.25 mg/d,至治疗结束。记录治疗前后两组内分泌激素、血清骨钙素(BGP)及骨密度变化。并随访两组停药后3、6个月的骨密度变化情况。结果两组患者内分泌水平均较治疗前降低,差异有明显统计学意义(P<0.05);BGP较治疗前有所上升,差异有统计学意义(P<0.05);A组骨密度均较治疗前降低,差异有统计学意义(P<0.05)。停药后3个月及6个月两组骨密度均未恢复至治疗前,但较治疗前比较无统计学差异(P>0.05)。结论单用GnRH-α治疗子宫内膜异位症3个月对骨密度无影响。
Objective To compare the effects of GnRH-α combined with short-term dose of tibolone on endocrine and bone loss in patients with endometriosis. Methods March 2015 - March 2016 in the First Affiliated Hospital of Xinjiang Medical University, a laparoscopic conservative surgery, pathology confirmed endometriosis, postoperative patients treated with GnRH-α 150 cases were randomly divided into single GnRH-α group (A group) and anti-add group (B group). B group from the first injection of GnRH-α at the same time oral tibolone 1.25 mg / d, to the end of treatment. The changes of endocrine hormones, serum BGP and bone mineral density were recorded before and after treatment. The changes of BMD in 3 and 6 months after discontinuation in both groups were followed up. Results The levels of endocrine in both groups were significantly lower than those before treatment (P <0.05), BGP increased compared with that before treatment (P <0.05), and the BMD in group A was significantly higher than that before treatment Before the reduction, the difference was statistically significant (P <0.05). BMD of the two groups did not recover before treatment after 3 and 6 months of treatment, but there was no significant difference between before and after treatment (P> 0.05). Conclusion Treatment of endometriosis with GnRH-α for 3 months had no effect on BMD.