黄体晚期服米非司酮对生育调节的影响及LIF在子宫内膜的表达

Late Luteal Administration of Mifepristone in Normal Women on Fertility Control and the Expression of LIFmRNA

目的探讨黄体晚期给予米非司酮对生育调节的影响及白血病抑制因子(LIF)在子宫内膜组织中的表达。方法300例育龄妇女随机分为5组,每组60例。A、B、C组预期月经来潮前3天口服米非司酮,总量分别为75mg、50mg、75mg,其中A、B组服米非司酮48小时后加服米索前列醇(米索)400μg;D、E组预期月经来潮前5天口服米非司酮,总量为75mg,其中E组服米非司酮48小时后加服米索400μg。观察各组服药的妊娠率、月经变化,电镜下子宫内膜超微结构的变化。用逆转录PCR方法半定量检测白血病抑制因子信使核糖核酸(LIFmRNA)在正常月经周期子宫内膜组织中表达的变化及黄体晚期应用米非司酮对子宫内膜组织中LIF表达的影响。结果5组黄体晚期应用米非司酮对月经周期无影响,各组继续妊娠率分别为6.25%、36.4%、55.6%、8.3%、10.0%。LIFmRNA在正常月经周期卵泡期、黄体早、中、晚期表达的相对量依次增高,黄体晚期应用米非司酮,LIFmRNA表达水平为0.61±0.05。结论米非司酮于黄体晚期应用降低子宫内膜组织中LIF表达可能是其抗生育的机理之一,能有效达到避孕目的。

Objective To understand the influence on the procreating regulation and the expression of LIF in the uterus membrane with mifepristone during the later period of corpus leteum.~Methods 300 voluntary women at the age of procreating were randomly divided into five groups,each of which contained 60 volunteers.Three days before expectation of the menstrual coming group A were given mifepristone,75 mg;Group B,50 mg;Group C, 75 mg.Among them,48 hours after given mifepristone,group A and B were given misoprlstol,400 μg;And five days before the expectation of the menstrual coming,group D and E were given mifepristone,75mg,but 48 hours after given mifepristone group E were given misopulstol, 400 ug.Besides,the change of the five groups'pregancy rate,menses and most tiny membrane organization of uterurs (by electronic microscope) were observed.Finally by the method of PCR,half quantitatively,the change of LIFmRNA expreeion in the membrane organization of uterus in the menstrual normal cycle,and the influence on the expression of LIF in the membrane organization of uterus were detected.~Results Every menstrual cycle of five group was normal and not affected by the application of mifeprstone during the later period of corpus leteum.Group A's onging pregnancy rete was 6.25%,B, 36.4%,C,55.6%,D, 8.3% and E,10%.The relative quantitative expression of LIFmRNE increased in furn in the menstrual cycle,in the period of follicular,and in the early,middle and later period.The level of LIFmRNE expression was 0.61±0.05 after administrating mifepristone during the later period of corpus leteum.Conclusion The LIF expression of the membrane organization,decreased by the application of mifepristone during the later period of corpus leteum,might be one of the preventing mechanisms from procreating,and would effectively reach the purpose of contraception.