阴道给药与肌内注射黄体酮对子宫内膜孕激素水平影响的研究

发布时间：2018-06-09 15:46

本文选题：黄体酮阴道缓释凝胶 + 子宫首过效应　；参考：《实用妇产科杂志》2017年03期

【摘要】：目的:探讨阴道给药和肌内注射黄体酮给药后在血中和子宫内膜激素水平的影响。方法:采用单中心、前瞻性、随机对照研究方法,随机选择2009年12月至2011年8月在北京协和医院妇科51例健康绝经后女性,知情同意后随机分为两组,临床常规给药剂量阴道给药组给予黄体酮阴道缓释凝胶90 mg阴道给药,肌内注射给药组肌内注射黄体酮油剂20 mg,两组均每日1次,连续用药7天。在给药5~7天后测定血激素水平,活检取子宫内膜组织并利用放射免疫法(RIA)测定内膜孕酮浓度。比较两组用药后子宫内膜组织中及血中孕酮浓度及用药前后血中孕酮浓度。结果:完成研究并符合条件共39例,两组基线水平包括年龄、停经时间、基础激素水平差异无统计学意义(P0.05),阴道给药组血中孕酮浓度与肌内注射组差异无统计学意义(P0.05)。阴道给药组子宫内膜孕酮浓度(11.13±11.44 nmol/L)与肌内注射组(2.54±1.90 nmol/L)比较,差异有统计学意义(P=0.005)。阴道给药组用药前后血孕酮浓度变化(20.03±12.08 nmol/L)与肌内注射组(19.71±9.22nmol/L)比较,差异无统计学意义(P=0.822)。结论:与肌内注射给药相比,阴道凝胶经阴道给药的子宫局部吸收更高,值得临床推广。
[Abstract]:Aim: to investigate the effects of vaginal administration and intramuscular injection of progesterone on serum and endometrial hormone levels. Methods: 51 healthy postmenopausal women from December 2009 to August 2011 in Beijing Union Hospital were randomly selected by a single center prospective randomized controlled study and were randomly divided into two groups after informed consent. The vaginal administration group was given progesterone vaginal sustained release gel 90 mg vaginal administration, intramuscular injection of 20 mg intramuscular injection of progesterone oil, the two groups were treated once a day for 7 days. Serum hormone levels were measured 7 days after administration, endometrial tissue was taken by biopsy and progesterone concentration was measured by RIA. The concentrations of progesterone in endometrial tissue and blood were compared between the two groups. Results: the baseline level of the two groups, including age, menopause time and basal hormone level, was not significantly different from that in the vaginal administration group (P 0.05), and there was no significant difference between the vaginal administration group and the intramuscular injection group (P 0.05). The endometrial progesterone concentration in vaginal administration group (11.13 卤11.44 nmol / L) was significantly higher than that in intramuscular injection group (2.54 卤1.90 nmol / L). There was no significant difference in serum progesterone concentration between vaginal administration group and intramuscular injection group (20.03 卤12.08 nmol / L) and intramuscular injection group (19.71 卤9.22 nmol / L). Conclusion: compared with intramuscular injection, vaginal gel has higher local absorption through vagina, and is worth popularizing.
【作者单位】：北京市通州区妇幼保健院;北京协和医院;北京朝阳医院;中南大学湘雅三医院;
【分类号】：R969

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