米非司酮治疗未破裂型异位妊娠的剂量探讨

Comparison between Different Dosages of Mifepristone in Treating Unruptured Ectopic Pregnancy

目的:探讨米非司酮(Ru486)治疗未破裂型异位妊娠的有效剂量。方法:102例未破裂型异位妊娠患者随机分3组。A组34例,75 mg/d;B组33例,225 mg/d;C组35例,600 mg/d×7 d,再450 mg/d×4 d,300 mg/d×3 d;疗程均14 d。结果:A、B组的治愈率分别为20.59％和27.27％,两组间无显著差异(P>0.05)。C组的治愈率为74.29％,明显高于A、B两组(P<0.01)。3组病例治疗前后的血尿常规、电解质、肝肾功能无明显的改变,但用药后B、C两组的血清皮质醇和尿24 h皮质醇明显升高。药物不良反应有恶心、呕吐、乏力、便秘、水肿及皮疹。结论:Ru486治疗未破裂型异位妊娠需大剂量用药才能有确切的疗效。

Objective: To investigate an effective dosage of mifepristone (Ru486) in treating unruptured ectopic pregnancy. Methods:A total of 102 patients with unruptured ectopic pregnancy were randomly divided into three groups. Ru486 were administrated respectively 25mg tidX14 days and 75mg tid × 14 days in groups A (n = 34) and B (n = 33). Ru486 was taken orally 200mg tid × 7 days, secondly 150mg tid×4 days and then 100 mg tid × 3 days in group C (n = 35). Results:the healing rates were 20. 59% and 27. 27% in groups A and B .respectively (P>0. 05). The healing rate in group C was 74. 29% and much higher than that in groups A or B (P<0. 01). Serologic examination and hepatorenal functions were not changed after treatment. Cortisols of serum and 24h urine increased after treatment in groups B and C. Nausea, vomiting, inertia, constipation, edema, and skin eruption were common side effects. Conclusion: High dosage of Ru486 should he administrated in unruptured ectopic pregnancy in order to achieve higher healing rate.