激素治疗对卵巢内膜瘤的影响:系统性审查和元分析
Peter S Thiel1, Francesca Donders2, Anna Kobylianskii1
1Department of Obstetrics and Gynecology (Drs. Thiel, Kobylianskii, and Murji), Mount Sinai Hospital, Toronto, ON, Canada; Department of Obstetrics and Gynecology, University of Toronto, Toronto, ON, Canada (Drs. Thiel, Kobylianskii, and Murji).
Journal of minimally invasive gynecology
|January 8, 2024
概括
激素抑制显著减少子宫内膜瘤的大小,平均在六个月后减少55%. 迪昂格斯特和其他特定疗法在缩小卵巢囊方面表现出最大的有效性.
科学领域:
- 生殖内分泌学 生殖内分泌学
- 妇科瘤学 妇科瘤学
背景情况:
- 子宫内膜异位症是一种在子宫外的子宫内膜状组织的特征,通常导致卵巢囊 (子宫内膜异位瘤).
- 荷尔蒙疗法通常用于管理子宫内膜异位症症状和疾病进展.
研究的目的:
- 系统地评估激素抑制对子宫内膜卵巢囊大小的影响.
- 分析不同类型的激素疗法在减少子宫内膜瘤体积方面的疗效.
主要方法:
- 在主要数据库 (MEDLINE,PubMed,Embase等) 进行了全面的文献搜索. 从2012年开始到2022年.
- 包括的研究集中在绝经前的妇女,接受了至少三个月的子宫内膜异位症激素治疗.
- 使用已知的工具评估了偏差风险,并将该协议注册在PROSPERO.
主要成果:
- 分析了16项涉及888名患者的研究,其中二诺,孕激素和荷尔蒙避孕药是常见的治疗方法.
- 激素抑制导致子宫内膜瘤体积在六个月后平均减少了55%的统计学意义.
- 迪恩格斯特和诺乙酸加上莱特醇显示了最显著的体积减少,而组合激素避孕药和其他孕药显示的效果不那么显著.
结论:
- 激素抑制是一种有效的策略,可以大幅减少子宫内膜卵巢囊的大小.
- 虽然可以实现显著的减少,但体积减少的确切程度可能因患者和治疗类型而异.
相关概念视频
Oogenesis
63.7K
In human women, oogenesis produces one mature egg cell or ovum for every precursor cell that enters meiosis. This process differs in two unique ways from the equivalent procedure of spermatogenesis in males. First, meiotic divisions during oogenesis are asymmetric, meaning that a large oocyte (containing most of the cytoplasm) and minor polar body are produced as a result of meiosis I, and again following meiosis II. Since only oocytes will go on to form embryos if fertilized, this unequal...
63.7K
Hormonal Regulation of the Menstrual Cycle
396
The ovarian cycle regulates endometrial changes throughout a single menstrual cycle via the coordinated action of gonadotrophin-releasing hormone (GnRH) and gonadotrophins.
At puberty, GnRH begins a pulsatile release pattern, which triggers the anterior pituitary gland to secrete follicle-stimulating hormone (FSH) and luteinizing hormone (LH). The frequency and amplitude of GnRH pulses vary across the menstrual cycle, with faster pulses favoring LH release and slower pulses favoring FSH...
At puberty, GnRH begins a pulsatile release pattern, which triggers the anterior pituitary gland to secrete follicle-stimulating hormone (FSH) and luteinizing hormone (LH). The frequency and amplitude of GnRH pulses vary across the menstrual cycle, with faster pulses favoring LH release and slower pulses favoring FSH...
396
Hormonal Control of the Ovarian Cycle
518
The ovarian cycle is meticulously regulated by the hypothalamic-pituitary-gonadal axis. This cycle orchestrates the release of a mature oocyte, essential for reproduction.
Before puberty, the hypothalamus releases GnRH in a low frequency, low amplitude pulsatile manner. This along with the immature hypothalamic-pituitary-gonadal axis activity, results in low estrogen levels and the absence of a fully functional ovarian cycle. At puberty, GnRH secretion increases in both frequency and...
Before puberty, the hypothalamus releases GnRH in a low frequency, low amplitude pulsatile manner. This along with the immature hypothalamic-pituitary-gonadal axis activity, results in low estrogen levels and the absence of a fully functional ovarian cycle. At puberty, GnRH secretion increases in both frequency and...
518


