米非司酮和去氧孕烯炔雌醇治疗围绝经期功能失调性子宫出血分析

Clinical analyse of mifepristone and desogestrel-ethinylestradiol in treatment of dysfunctional uterine bleeding in perimenopausal period

目的:比较和分析2种治疗围绝经期功能失调性子宫出血药物的临床效果。方法:采用回顾性分析方法对2003年7月—2006年7月我院80例围绝经期功血病人分别进行米非司酮和去氧孕烯炔雌醇治疗比较。结果:米非司酮组治疗有效率98%,去氧孕烯炔雌醇组治疗有效率100%,2组差异无显著意义(P>0.05);2组治疗后血清雌二醇(E_2)、孕酮(P)均下降,治疗前后差异具有非常显著意义(P<0.01),卵泡刺激素(FSH)、黄体生成素(LH)下降但无显著意义(P>0.05),催乳素(PRL)、睾酮(T)相对稳定;米非司酮组治疗后39例子宫内膜变薄,有1例出现子宫内膜异常增生;氧孕烯炔雌醇组治疗后子宫内膜均变薄,差异有显著意义(P<0.05)。2组不良反应均轻微。结论:米非司酮和去氧孕烯炔雌醇治疗围绝经期功能失调性子宫出血的临床效果相当,长期应用米非司酮应注意其安全性。

AIM： To assess the efficacy of mifepristone and desogestrel-ethinylestradiol in treatment of dysfunctional uterine bleeding in perimenopausal period. METHODS： The results of mifepristone and desogestrel-ethinylestradiol treatment were analyzed retrospectively in 80 patients with perimenopausal-period dysfunctional uterine bleeding from July 2003 to July 2006. RESULTS： There was no statistical difference in effective rate of mifepristone group （ 98 % ） and desogestrel-ethinylestradiol group （ 100 % ） （ P 〉 0.05）. Compared with pro-treatment, the level of estradiol （E2） and progesterone （P） in the two groups statistically decreased （P 〈 0.01 ）, and the level of follide stimulating hormone （FSH） and lutenizing hormone （LH） had a declined tendency but with no statistical difference, while there was no remarkable changes in prolactin （PRL） and testosterone （T） （P 〉 0.05） . There were 39 patients whose endometrial thickness became thinner after mifepristone treatment, but the significant growth of endometrium occurred in one patient; endometrial thickness becoming thinner occurred in all patients treated by desogestrel-ethinylestradiol （P 〈 0.05） . Two groups both had few adverse reactions. CONCLUSION： Mifepristone is as effective as desogestrel-ethinylestradiol in treatment of perimenopausal-period dysfunctional uterine bleeding, and the safety of long-time mifepristone treatment should be thought about.