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[1]董丽丽,李银凤,刘改文,等.炔雌醇环丙孕酮对原发免疫性血小板减少症致异常子宫出血患者的临床疗效[J].医学研究与战创伤救治(原医学研究生学报),2020,22(3):234-238.[doi:10.3969/j.issn.1672-271X.2020.03.003]
　DONG Li-li,LI Yin-feng,LIU Gai-wen,et al.Clinical effect of ethinylestradiol and cyproterone acetate on abnormal uterine bleeding caused by primary immune thrombocytopenia[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2020,22(3):234-238.[doi:10.3969/j.issn.1672-271X.2020.03.003]
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炔雌醇环丙孕酮对原发免疫性血小板减少症致异常子宫出血患者的临床疗效()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第22卷
期数:
2020年3期
页码:
234-238
栏目:
临床研究
出版日期:
2020-05-15

文章信息/Info

Title:
Clinical effect of ethinylestradiol and cyproterone acetate on abnormal uterine bleeding caused by primary immune thrombocytopenia
作者:
董丽丽; 李银凤; 刘改文; 陈玉莹; 白月
作者单位：010000呼和浩特，呼和浩特市第一医院妇产科（董丽丽、李银凤、刘改文、陈玉莹、白月），药剂科（陈玉莹）
Author(s):
DONG Li-li1; LI Yin-feng1;  LIU Gai-wen1;  CHEN Yu-ying2;  BAI Yue1
（1. Department of Obstetrics and Gynecology, 2. Department of Pharmacy, Hohhot First Hospital, Hohhot 010000, Inner Mongolia, China）
关键词:
炔雌醇环丙孕酮; 原发免疫性血小板减少症; 异常子宫出血; 血小板; 血红蛋白; 凝血四项; 子宫内膜厚度
Keywords:
ethinylestradiol and cycloproterone acetate;  primary immunity thrombocytopenia;  abnormal uterine bleeding;  platelet;  hemoglobin;  four items of coagulation;  endometrial thickness
分类号:
R714.21
DOI:
10.3969/j.issn.1672-271X.2020.03.003
文献标志码:
A
摘要:
目的观察炔雌醇环丙孕酮对原发免疫性血小板减少症（ITP）致异常子宫出血患者的临床疗效。方法选择2017年1月至2018年5月期间呼和浩特市第一医院治疗的ITP致异常子宫出血患者70例，按照随机数字表法分为2组，每组35例，其中对照组采取对症治疗，孕酮组在对照组基础上加用炔雌醇环丙孕酮治疗，比较2组患者治疗前、治疗1个月、3个月和6个月后的血小板、血红蛋白含量变化，凝血四项指标[凝血酶原时问（PT）、活化部分凝血酶时间（APTT）、凝血酶时间（TT）、纤维蛋白原（FIB）] 的变化，以及平均输血小板量、止血时间和子宫内膜厚度等。结果孕酮组在治疗1个月、3个月和6个月后的血小板含量[（5.46±0.56、6.89±0.69、7.45±0.75）×109/L]、血红蛋白含量[（53.45±3.45、59.75±3.05、61.58±2.69）g/L]均高于对照组[（3.95±0.58、4.18±0.48、5.01±0.58）×109/L,（48.54±3.58、50.65±2.54、52.41±2.75）g/L，P＜0.05]，平均输血小板量[（5.45±0.74、4.25±0.45、4.25±0.26）单位/月]均低于对照组[（7.42±0.86、6.68±0.65、5.86±0.51）单位/月，P＜0.05]。治疗后孕酮组出血控制时间[（66.81±11.31）h]和完全止血时间[（66.81±11.31）h]均短于对照组[(86.19±12.02)h, (86.19±12.02）h，P＜0.05]。2组患者治疗后子宫内膜厚度均较治疗前下降（P＜0.05），孕酮组治疗后子宫内膜厚度[（6.77±1.15）mm]低于对照组[（8.28±1.21）mm]，差异有统计学意义（P＜0.01）。结论对于ITP致异常子宫出血患者可采用加炔雌醇环丙孕酮进行治疗，在缩短出血时间，减少输血小板量方面有效更优，维持且相对增加血红蛋白和血小板量，且对患者其他凝血指标无明显影响。该治疗方法值得临床推广应用。
Abstract:
ObjectiveTo study the clinical effect of ethinylestradiol and cycloproterone acetate on abnormal uterine bleeding caused by primary immune thrombocytopenia (ITP).MethodsSeventy patients with abnormal uterine bleeding caused by ITP in our hospital from January 2017 to May 2018 were average divided into two groups, according to the random number table method. The control group received symptomatic treatment, and the research group was treated with ethinylestradiol and cycloproterone acetate on the basis of the symptomatic treatment. The changes of platelet and hemoglobin contents, four coagulation indexes (PT, APTT, TT, FIB),average platelet transfusion, hemostasis time and endometrial thickness were compared before treatment, 1, 3 and 6 months after treatment.ResultsAfter 1, 3 and 6 months of treatment，the platelet content [（5.46±0.56，6.89±0.69，7.45±0.75）×109/L], hemoglobin content [（53.45±3.45，59.75±3.05，61.58±2.69）g/L] in the study group were higher than those in the control group [（3.95±0.58，4.18±0.48，5.01±0.58）×109/L,（48.54±3.58，50.65±2.54，52.41±2.75）g/L，P＜0.05]. The mean platelet transfusion volume [（5.45±0.74，4.25±0.45，4.25±0.26）unit/month] in the study group was lower than that in the control group [（7.42±0.86，6.68±0.65，5.86±0.51）unit/month，P＜0.05]. The bleeding control time [（19.77±8.18）h] and complete hemostasis time [（66.81±11.31）h] in the study group were shorter than those in the control group [(26.42±9.57)h, (86.19±12.02）h，P＜0.05]. The endometrial thickness of two groups after treatment were lower than that before treatment (P<0.05). The endometrial thickness of the study group after treatment [(6.77±1.15)mm] was lower than that of the control group [(8.28±1.21)mm](P<0.01).ConclusionPatients with abnormal uterine bleeding due to primary immune thrombocytopenia can be treated with ethinyl estradiol and progesterone. Treatment with ethinyl estradiol and progesterone tablets can significantly reduce bleeding time, reduce platelet transfusion, and maintain and relatively increase the amount of hemoglobin and platelets without any significant effect on other coagulation parameters of the patient. This treatment is worthy of clinical promotion and application.

参考文献/References:

[1]马娟萍,杨红娟.炔雌醇环丙孕酮片与去氧孕烯炔雌醇片治疗青春期功能失调性子宫出血的效果[J].临床医学研究与实践,2019,4(13):103-105.
[2]李磊.炔雌醇环丙孕酮片联合戊酸雌二醇片治疗功能性子宫出血的疗效观察[J].实用妇科内分泌电子杂志,2016,3(4):108-109.
[3]高红玲,蔡炜琼.炔雌醇环丙孕酮片治疗无排卵性功能失调性子宫出血的疗效观察[J].中国医院用药评价与分析,2018,18(4):468-470.
[4]Hanson MA, Bardsley A, De-Regil LM, et al. The International Federation of Gynecology and Obstetrics (FIGO) recommendations on adolescent, preconception, and maternal nutrition: "Think Nutrition First"[J]. Int J Gynaecol Obstet, 2015,131(8):213-253.
[5]费梦,范文.米非司酮与醋酸甲羟孕酮片对异常子宫出血患者子宫内膜厚度及生殖激素的影响[J].湖南师范大学学报（医学版）,2019,16(2):154-157.
[6]张郡,宿宓,许良智,等.炔雌醇环丙孕酮片与去氧孕烯炔雌醇片的长期应用对多囊卵巢综合征的疗效及代谢安全性[J].南方医科大学学报,2018,38(8):917-922.
[7]张慧,王瑞玲,李群英,等.二甲双胍与炔雌醇环丙孕酮治疗多囊卵巢综合征的疗效及对性激素、血糖水平的影响[J].疑难病杂志,2016,15(6):621-624.
[8]张静,刘文枝,雷龙涛,等.炔雌醇环丙孕酮联合吡格列酮治疗PCOS伴2型糖尿病不孕患者的临床效果[J].中国计划生育学杂志,2018,26(5):362-366.
[9]Kim MK, Seong SJ, Song T, et al. Comparison of dilatation & curettage and endometrial aspiration biopsy accuracy in patients treated with high-dose oral progestin plus levonorgestrel intrauterine system for early-stage endometrial cancer[J]. Gynecol Oncol, 2013, 130(3):470-473.
[10]Jiang Y, Liu N, Zhu S, et al. Elucidation of the mechanisms and molecular targets of Yiqi Shexue formula for treatment of primary immune thrombocytopenia based on network pharmacology[J]. Front Pharmacol, 2019,10(10):1136.
[11]李春红.戊酸雌二醇、炔雌醇环丙孕酮联合克罗米芬胶囊治疗多囊卵巢综合征80例观察[J].中国药师,2016,19(8):1532-1534.
[12]蔡丽艳.去氧孕烯炔雌醇片与左炔诺孕酮节育系统在排卵障碍性异常子宫出血治疗中的应用[J].中国计划生育学杂志,2019,27(1):57-60.
[13]韩金秀.左炔诺孕酮宫内节育系统和安宫黄体酮在围绝经期异常子宫出血治疗中的疗效观察[J].中国当代医药,2016,23(14):60-62.
[14]刘少津,万雷,乔荣勤,等. 雌激素相关受体α对沉默重组腺病毒载体转染MG63细胞和骨相关蛋白的影响[J]. 医学研究生学报,2018,31(9):904-909.
[15]Sakamoto K, Nakasone H, Tsurumi S, et al. Prednisone versus high-dose dexamethasone for untreated primary immune thrombocytopenia. A retrospective study of the Japan Hematology & Oncology Clinical Study Group[J]. J Thromb Thrombolysis, 2014, 37(3): 279.
[16]Nakayama Y, Nakajima Y, Tanaka KA, et al. Thromboelastometry-guided intraoperative haemostatic management reduces bleeding and red cell transfusion after paediatric cardiac surgery[J]. Br J Anaesth, 2015, 114(1):91-102.

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备注/Memo

备注/Memo:
基金项目：内蒙古自治区卫生和计划生育委员会科研计划项目（201703148）
更新日期/Last Update: 2020-05-15