米非司酮对人蜕膜雌、孕激素受体及血清生殖激素的影响

TheEffectofMifepristoneonProgesteroneandEstrogenReceptorsinHumanDeciduaandSerumHormoneLevels

目的：了解米非司酮对人蜕膜雌激素受体（ＥＲ）、孕激素受体（ＰＲ）和生殖激素的影响，探讨米非司酮的抗早孕机理。方法：应用葡聚糖活性碳吸附（ＤＣＣ）法和酶联组化法测定正常和服米非司酮１００ｍｇ后的人蜕膜组织ＥＲ、ＰＲ；采用放射免疫法检测血清β－ｈＣＧ、雌二醇（Ｅ２）、睾酮（Ｔ）和孕酮（Ｐ）的水平。结果：口服米非司酮１００ｍｇ后，人蜕膜组织胞浆ＰＲ明显减少（Ｐ＜０．０５），而胞浆ＥＲ明显增多（Ｐ＜０．０５）；酶联组化分析显示，米非司酮诱使血管、腺细胞内的ＥＲ染色增强。服米非司酮后β－ｈＣＧ、Ｅ２和Ｔ均显著增加（Ｐ＜０．０１，Ｐ＜０．０１和Ｐ＜０．０５），Ｐ无明显改变。结论：米非司酮可能通过减少蜕膜ＰＲ含量，增加ＥＲ水平，干扰ＥＲ与ＰＲ之间的平衡及升高血清Ｔ浓度，而起到抗早孕作用。

Objectives:Toexaminetheeffectsofmifepristoneonprogesteroneandestrogenre-ceptorsinhumandeciduaandsteroidhormonelevelsinserumforinvestigatingthemechanismsofantigestationalactionofmifepristone.Methods:Decidualprogesteronereceptor(PR)andestrogenreceptor(ER)concentrationsorbindingsitesweremeasuredbybothdextrancoatedcharcoal(DCC)andhistochemicalmethodsinnormalsubjectsandafter100mg-mifepristonetreatment.Meanwhile,theconcentrationsofserumβ-humanchorionicgonadotropin(β-hCG),estradiol(E2),progesterone(P)andtestosterone(T)werealsodeterminedbyradioimmunoasssay.Thereactionsofthesetwogroupswerecompared.Results:MifepristonetherapysignificantlyreduceddecidualcytosolPRcon-tent(P<0.05)andincreaseddecidualcytosolERcontent(P<0.05).Histochemicalanalysesindi-catedmifepristonetreatmentincreasedERstaininginvesselandglandularcelsofdecidua.Theserumβ-hCG,E2andTlevelselevatedsignificantlyaftermifepristoneadministration,whilethepro-gesteronelevelswereunafected.Conclusion:Ourdatasuggestedthattheanti-gestationaleffectofmifepristonemayactthroughdecreasingthedecidualPRandincreasingtheERconcentrations,whichinterferedthebalancebetweenthesetwocomponents,andalsothroughincreasingserumTlevels.