Fertirelin Txhaj

Daim ntawv thov scenario: Anovulatory infertility account rau ib qho tseem ceeb ntawm cov poj niam infertility, kwv yees li 30%. Ntawm lawv, cov neeg mob uas muaj polycystic zes qe menyuam syndrome (PCOS) yog ib qho kev pheej hmoo siab - pab pawg muaj kev pheej hmoo rau anovulatory infertility. Cov neeg mob PCOS muaj ntau lub hauv paus me me hauv lawv lub zes qe menyuam, tab sis cov follicles no feem ntau tsis txhim kho thiab loj hlob zoo, ua rau muaj menyuam tsis taus. Cov txheej txheem kev kho mob feem ntau yog nyob ntawm ovulation inducing tshuaj xws li clomiphene. Txawm li cas los xij, cov tshuaj no muaj qee yam kev pheej hmoo thaum siv, uas tuaj yeem ua rau zes qe menyuam hyperstimulation syndrome (OHSS). OHSS yog ib qho teeb meem loj iatrogenic, thiab cov neeg mob yuav ntsib cov tsos mob xws li zes qe menyuam, ascites, thiab pleural effusion. Hauv qhov xwm txheej hnyav, nws tuaj yeem ua rau muaj kev phom sij rau lawv lub neej, ua rau muaj kev hem thawj rau lawv lub cev kev noj qab haus huv thiab kev nyab xeeb.

Tus nqi kho mob: Ib qho kev soj ntsuam randomized ua los ntawm 200 PCOS cov neeg mob tau pom tias muaj txiaj ntsig zoo hauv kev kho mob anovulatory infertility. Cov txiaj ntsig kev sim tau pom tias tom qab kho nrog Flutilin, ovulation tus nqi ntawm cov neeg mob tau nce mus txog 85%, thiab cev xeeb tub nce mus txog 40%, uas yog siab dua li cov pab pawg kho mob clomiphene (ovulation tus nqi ntawm 65%, cev xeeb tub ntawm 25%). Tsis tas li ntawd, lub voj voog kho mob luv luv, feem ntau tsuas yog 5-10 hnub, uas txo qis lub cev thiab lub siab lub ntsws rau cov neeg mob thaum lub sijhawm kho thiab ua kom muaj kev ua raws cai. Ntau tus neeg mob, tom qab tau txais kev kho mob, tsis tsuas yog ua tiav ovulation thiab cev xeeb tub, tab sis kuj zam cov kev mob tshwm sim loj uas cov tshuaj kho mob tuaj yeem coj los, thiab lawv lub neej zoo tau txhim kho.

Mechanism of action: Cov tiam ntawm txiv neej phev yog ib tug complex thiab meej txheej txheem uas tso siab rau cov synergistic nyhuv ntawm follicle stimulating hormone (FSH) thiab testosterone. FSH feem ntau yog zais los ntawm lub caj pas pituitary thiab tuaj yeem txhawb nqa cov tubules seminiferous ntawm cov noob qes, txhawb kev tsim cov phev thiab kev loj hlob. Testosterone feem ntau yog secreted los ntawm testicular interstitial hlwb thiab plays lub luag hauj lwm tseem ceeb hauv phev maturation thiab tswj cov txiv neej kev ua haujlwm. Los ntawm kev txhawb nqa lub caj pas pituitary kom zais FSH thiab txhim kho kev ua haujlwm ntawm cov qe menyuam hauv plab, kev txhawb nqa cov tshuaj hormone txaus yog muab rau cov phev ntau lawm, yog li txhawb cov phev ntau lawm. Nyob rau tib lub sijhawm, nws tseem tuaj yeem tswj hwm qib testosterone kom tswj tau lawv nyob rau hauv qhov qub, txhim kho txiv neej kev ua haujlwm, thiab txhim kho qhov zoo thiab qhov tseem ceeb ntawm cov phev.

Kev kho mob tus nqi: Hauv kev kho mob ntawm txiv neej infertility, kev sib xyaw ua ke ntawm testosterone supplementation kho tau pom tias muaj txiaj ntsig zoo heev. Cov kev tshawb fawb soj ntsuam tau pom tias tom qab siv txoj kev kho ua ke no, tus neeg mob cov phev suav tuaj yeem nce ntxiv los ntawm<5 × 10 ⁶/mL to>20 × 10 ⁶ / mL, muab ntau lub sijhawm rau kev xeeb tub. Nyob rau tib lub sijhawm, tus poj niam cev xeeb tub kuj tau nce mus rau 35%, thiab ntau tus niam txiv uas yav tas los tsis tuaj yeem xeeb tub vim phev tsis muaj peev xwm tau txais tos lawv cov menyuam los ntawm txoj kev kho mob no. Qhov kev pab cuam no yog tshwj xeeb tshaj yog haum rau cov neeg mob uas muaj hypogonadotropic hypogonadism (IHH), muab lawv nrog kev kho mob zoo thiab pab lawv ua tiav lawv cov kev npau suav kev yug me nyuam.

Daim ntawv thov scenario: Endometriosis yog ib hom kab mob ntawm cov poj niam uas muaj hnub nyoog me nyuam, uas tuaj yeem muaj ntau yam tsis zoo rau lawv lub cev noj qab haus huv thiab lub neej zoo. Cov neeg mob feem ntau muaj cov tsos mob xws li dysmenorrhea, kev coj khaub ncaws tsis zoo, thiab thaum muaj mob hnyav, kev xeeb tub. Cov kev siv tshuaj kho mob feem ntau yog vam khom rau kev phais lossis tshuaj progesterone, tab sis kev phais muaj qee yam txaus ntshai thiab muaj tus nqi siab tom qab rov ua haujlwm dua; Txawm hais tias cov tshuaj progesterone tuaj yeem txo cov tsos mob, kev siv sijhawm ntev - tuaj yeem ua rau muaj kev phiv loj xws li qhov hnyav nce, kev xav hloov pauv, thiab lwm yam, cuam tshuam rau cov neeg mob lub cev noj qab haus huv thiab lub neej zoo.

Tus nqi kho mob: Kev sim tshuaj ntsuam xyuas 6 lub hlis ntsuas qhov ua tau zoo ntawm Furirelin hauv kev kho mob endometriosis. Cov kev sim tau pom tias tom qab kho nrogkev txhaj tshuaj fertirelin, tus neeg mob tus qhab nia dysmenorrhea tau txo qis los ntawm 60%, uas txhais tau hais tias tus neeg mob cov tsos mob ntawm qhov mob tau txo qis thiab lawv lub neej zoo tau zoo dua qub. Nyob rau tib lub sijhawm, kev coj khaub ncaws poob qis los ntawm 75% mus rau 20%, thiab kev coj khaub ncaws maj mam rov zoo li qub. Tsis tas li ntawd, lub cev xeeb tub ntawm cov neeg mob tau nce mus rau 25%, thiab ntau tus neeg mob uas yav tas los tsis muaj menyuam vim endometriosis tau ua tiav cev xeeb tub. Qhov tseem ceeb tshaj, cov tshuaj muaj kev cuam tshuam tsawg kawg nkaus ntawm zes qe menyuam kev ua haujlwm thiab yuav tsis cuam tshuam rau tus neeg mob lub neej yav tom ntej fertility, ua rau nws tsim nyog rau cov neeg mob uas xav tau kev xeeb tub.

Daim ntawv thov scenario: Cov tshuaj estrogen hauv cov neeg mob cancer mis premenopausal feem ntau yog siab, thiab kev loj hlob thiab kev loj hlob ntawm cov qog hlwb feem ntau nyob ntawm qhov stimulation ntawm estrogen. Cov txheej txheem kho ib txwm siv tsuas yog nyob ntawm oophorectomy lossis tshuaj -induced castration. Txawm hais tias oophorectomy tuaj yeem txo qis cov tshuaj estrogen sai, nws tuaj yeem ua rau lub cev tsis zoo rau cov neeg mob, cuam tshuam rau lawv cov fertility thiab endocrine tshuav nyiaj li cas; Txawm hais tias tshuaj-induced castration kuj tsis yog-invasive, nws kuj yuav muaj kev phiv loj thiab tsis ruaj khov, uas tuaj yeem cuam tshuam loj rau cov neeg mob lub cev noj qab haus huv thiab lub neej zoo.

Tus nqi kho mob: Ib txoj kev tshawb fawb multicenter uas muaj txog 1000 tus neeg mob premenopausal nrog mob qog noj ntshav mis ntsuas qhov kev kho mob ntawm futirelin nrog tamoxifen. Cov txiaj ntsig kev tshawb fawb pom tau tias tom qab 5 xyoos ntawm kev kho mob nrog Furirelin ua ke nrog Tamoxifen, tus kab mob - cov neeg mob muaj sia nyob dawb tau mus txog 85%, thiab tag nrho cov ciaj sia taus mus txog 90%. Cov ntaub ntawv no tsis txawv txav ntawm pawg phais castration, qhia tau hais tias kev sib xyaw ua ke muaj txiaj ntsig zoo ib yam li kev phais castration hauv inhibiting qog recurrence thiab ntev tus neeg mob ciaj sia. Tsis tas li ntawd, qhov tshwm sim ntawm osteoporosis nyob rau hauv pab pawg kho mob tau txo qis los ntawm 40%, thiab cov xwm txheej ntawm cov hlab plawv poob los ntawm 25%. Osteoporosis thiab kab mob plawv yog cov teeb meem kev noj qab haus huv tseem ceeb uas cov neeg mob qog noj ntshav tau ntsib nyob rau lub sijhawm ntev - txoj kev ciaj sia. Kev siv tuaj yeem txo qhov kev pheej hmoo ntawm cov teeb meem no, txhim kho lub neej zoo ntawm cov neeg mob, thiab muab kev lav phib xaub rau ntev -kev noj qab haus huv ntawm cov neeg mob.

Daim ntawv thov scenario: Kev loj hlob ntawm cov qog nqaij hlav qog nqaij hlav prostate yog nyob ntawm qhov stimulation ntawm testosterone, thiab siab dua cov qib testosterone, qhov kev loj hlob sai ntawm cov qog hlwb. Cov txheej txheem kev kho mob feem ntau yog nyob ntawm kev phais castration lossis tshuaj tiv thaiv androgen. Kev phais castration tuaj yeem ua rau lub cev raug mob thiab kev puas siab puas ntsws rau cov neeg mob, cuam tshuam rau lawv lub neej zoo; Txawm hais tias cov tshuaj tiv thaiv androgen tuaj yeem cuam tshuam cov teebmeem ntawm testosterone, kev siv sijhawm ntev - tuaj yeem ua rau cov tshuaj tiv thaiv hauv cov qog hlwb, thiab cov neeg mob ua rau muaj kev phiv xws li kub flashes thiab txo libido, cuam tshuam rau lawv lub cev thiab lub hlwb.

Tus nqi kho mob: Hauv kev kho mob ntawm cov neeg mob qog noj ntshav siab tshaj plaws, kev kho mob ua ke ntawmkev txhaj tshuaj fertirelinthiab Bicalutamide tau qhia txog qhov zoo. Cov kev tshawb fawb soj ntsuam tau pom tias tom qab siv cov kev kho mob sib xyaw ua ke no, cov neeg mob cov ntshav testosterone qib tuaj yeem raug txo kom tsawg<50ng/dL, and tumor progression time can be prolonged to 18 months, which is significantly better than the monotherapy group (12 months). This means that combination therapy can more effectively control the growth and spread of tumors, prolonging the survival of patients. In addition, this plan can also reduce the occurrence of side effects such as hot flashes and decreased libido, improve the quality of life of patients, and enable them to maintain a good physical and mental state during the therapeutic process, and better cope with the disease.