米非司酮治疗子宫内膜异位症的疗效观察

The safety and efficacy of low-dose mifepristone for endometriosis

目的观察米非司酮治疗子宫内膜异位症的疗效及其对性激素和子宫内膜的影响。方法经确诊子宫内膜异位症病人50例，月经d3—5开始口服米非司酮，每次25mg／d，连续服14d，继以10mg／d，连续服药2mo，随后10mg，隔天1次，连续用药2mo，继以维持剂量每3d10mg，连续2mo，共计用药时间为6．5mo。观察病人的症状、体征、B超检查征象改变及不良反应，并检测用药前、用药3mo、用药6．5mo、停药后3mo的性激素水平以及用药后的子宫内膜情况。结果所有病人经治疗后都出现闭经，症状和体征得到不同程度的改善，症状、体征明显改善占75．9％，改善占24．1％；B超显示显效者占76．5％，有效者占23．5％。用药6．5mo血孕激素及雌二醇水平比用药前显著降低（P〈0．01），但停药3mo又恢复至用药前水平；卵泡刺激素及黄体生成素水平则无明显变化。用药后出现轻微潮热9例：性欲减退4例，轻度食欲减退2例。无其它明显不良反应。用药6．5mo后子宫内膜病理证实无异常表现。结论用米非司酮治疗子宫内膜异位症疗效明显且安全，激素水平停药后无明显变化，无低雌激素的不良反应。

Objective The aim was to assess long-term effects of low-dose mifepristone on endometriosis, hormones, and endometrial pathology. Methods 50 randomized women with endometriosis were controlled to take oral mifepristone （25mg/d＊14days-10mg/d＊60days-10mg/qod＊60days-10mg/q3d＊60days） on the 3ra-5m day in the period for 6t/2 months. We followed up the symptom, side-effect, ultrasound, hormone levels and endometriurfi. Results The symptoms of all cases were ameliorated. Progesterone and estradiol were obviously decreased （P〈0.01） and rebounded to original level 3 months later since stopping the mifepristone. FSH and LH were no change. Although some cases had little side effect, there was no abnormal endometrial pathology change in long-term and low-dose treatment. Condusions It was indicated that the long-term and low-dose mifepristone treatment in endometriosis was safe, efficient and no obvious change in hormone. Low estrogen level can be avoided.