地屈孕酮临床应用专家共识OA
Expert consensus on the clinical application of dydrogesterone
地屈孕酮是结构最接近天然的孕激素药物,具有高度的孕激素受体选择性,几乎不对雌激素、雄激素或糖皮质激素受体产生亲和力.自1961年以来,地屈孕酮已在100多个国家临床应用.本专家共识基于牛津循证医学中心证据等级,系统阐述地屈孕酮在先兆流产、复发性流产、辅助生殖技术(ART)中黄体支持等生殖产科领域,以及在异常子宫出血(AUB)、闭经、经前期综合征、痛经、子宫内膜异位症、绝经激素治疗(MHT)等妇科疾病中的应用方案及疗效证据,在上述多个领域证据级别为Ⅱ级.同时,本专家共识还给出了相应的推荐意见.此外,地屈孕酮在其他妊娠和非妊娠相关领域的应用还在不断被探索和积累临床数据与经验.目前研究证明,地屈孕酮安全性、耐受性良好,不增加妊娠并发症、胎儿先天畸形等风险.
Dydrogesterone is a progestogen structurally closest to natural progesterone,with high selectivity for progesterone receptors and negligible affinity for estrogen,androgen,or glucocorticoid receptors.It has been used clinically in over 100 countries since 1961.According to the Oxford Centre for Evidence-Based Medicine levels of evidence,this expert consensus systematically reviews the clinical regimensand efficacy of dydrogesterone in reproductive and obstetric indications(threatened abortion,recurrent miscarriage,luteal phase support in ART)and gynecological disorders(abnormal uterine bleeding,amenorrhea,premenstrual syndrome,dysmenorrhea,endometriosis,menopausal hormone therapy),with Level Ⅱ evidence in multiple indications.At the same time,this expert consensus also provides corresponding recommendations.Further clinical data are being accumulated in other pregnancy and nonpregnancy related conditions.Available studies confirm favorable safety and tolerability,with no increased risks of pregnancy complications or congenital malformations.
中华预防医学会生育力保护分会;中华医学会围产医学分会;田秦杰
中国医学科学院北京协和医院
医药卫生
地屈孕酮流产黄体支持不孕症辅助生殖技术异常子宫出血闭经痛经子宫内膜异位症绝经激素治疗
DydrogesteroneMiscarriageLuteal phase supportInfertilityAssisted reproductive technologyAbnormal uterine bleedingAmenorrheaDysmenorrheaEndometriosisMenopausal hormone therapy
《生殖医学杂志》 2026 (5)
569-578,10
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