Yeşim BAYTUR, Yıldız UYAR, Barış ÇOBAN, Ümit İNCEBOZ, H. Tayfun ÖZÇAKIR, Hüsnü ÇAĞLAR

GNRH agonist tedavisinin premenopozal myomu olan kadınlarda uterin arter kan akımı üzerine etkisi

Giriş: Bu çalışmada amaç, GNRH agonisti goserelin tedavisinin premenapozal myomlu kadınlarda uterin arter kan akımı üzerine etkisini araştırmaktır. Gereç ve Yöntem: Kliniğimizde preoperatif olarak goserelin tedavisi uygulanan 10 myoma uteri hastası, tedavi almamış, benzer yaş grubunda, vücut kütle indeksinde ve myom volümünde 10 kontrol hastası ile eşleştirildi. Tedavi öncesi ve sonrasında myom ve uterus volümü, uterin arter rezistans indeksi, renkli Dopler ultrasonografi kullanılarak ölçüldü. Bu parametrelerde tedavi sonrası değişiklik olup olmadığı, myom volümündeki değişiklik ile uterin arter rezistansı arasındaki korelasyon, ayrıca, goserelin sonrası uterin arter rezistans indeksinde, tedavi almayan kontrol gurubundan farklılık olup olmadığı araştırıldı. İstatistiksel araştırmalar SPSS 10.0 programı ile, bağımsız non-parametrik değişkenler için Mann- Whitney U testi, tekrarlayan non-parametrik ölçümler için Wilcoxon Signed rank test kullanılarak yapıldı. Korelasyon testi olarak Spearman testi kullanıldı. P< 0,05 istatistiksel olarak anlamlı kabul edildi. Bulgular: Goserelin alan gurupta myom ve uterus volümü tedavi sonrasında anlamlı ölçüde azaldı. (99,5 ± 101,5'e karşı 55,4 ± 59,4 cm3 , uterusda 283,25 ± 248,5'e karşı 202,1 ± 138,2 cm3 )(p

Anahtar Kelimeler:

Kan akım hızı, Miyom, Uterus, Goserelin, Premenopoz, Ultrasonografi, doppler, Gonadotropin-serbestleştirici hormon

The effect of GnRH agonist treatment on uterine artery blood flow in premenopausal women with leiomyoma

Introduction: The aim of the study is to investigate the effect of GnRH agonist goserelin on the uterine artery blood flow in premenopausal women with leiomyoma. Material and Method: Ten women with leiomyoma who were treated with goserelin preoperatively in our clinic, matched with ten control patient with similar age, body mass index and leiomyoma volume. Leiomyoma and uterus volume, uterine artery resistans index were measured before and after treatment using color Doppler ultrasound.These variables were compared in gosereiin patients. Furthermore, uterine artery resistans index were also compared between gosereiin and control patients. Statistical analysis was performed on SPSS version 10.0 using Mann-Whitney U test for non-parametric unrelated variables and Wiicoxon Signed Rank test for non-parametric repeated variables. Spearman test was used for correlations. P< 0,05 was considered significant. Results: Leiomyoma and uterus volume significantly decreased after treatment in gosereiin group ( 99,5 ± 101,5 versus 55,4 ± 59,4 cm3 in leiomyoma, 283,25.± 248,5 versus 202,1 ± 138,2 cm3 in uterus)(p< 0,05). Uterine artery resistans index didn't show any significant changes between before and after treatment in gosereiin group (0,73 ±0,1 versus 0,71 ± 0,17) (p> 0,05). Furthermore, uterine artery resistans index was not different in the control group from gosereiin group after treatment (0,74 ±0,1). Conclusion: Preoperative gosereiin treatment decreases leiomyoma volume effectively. But this effect seems to be Jndependent from uterine blood flow.

Keywords:

Blood Flow Velocity, Myoma, Uterus, Goserelin, Premenopause, Ultrasonography, Doppler, Gonadotropin-Releasing Hormone,

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