小剂量米非司酮对单纯型增生子宫内膜的影响

The research of low-dose mifepristone on the treatment of anovulatory functional uterine bleeding

目的探讨小剂量米非司酮对单纯型增生子宫内膜的影响。方法把研究对象随机分为米非司酮组43例，炔诺酮组43例，对照组20例。用药前和停药后进行子宫内膜病理组织学检查并检测子宫内膜组织雌激素受体（ER）和孕激素受体（PR）水平，同时测定子宫内膜厚度和Hb含量。结果研究组用药前子宫内膜均为单纯型增生。使用米非司酮和炔诺酮后，子宫内膜呈增生期反应，与用药前相比差异有统计学意义（P〈0．05），两组用药后比较，差异无统计学意义（P〉0．05）。研究组用药后子宫内膜细胞ER和PR阳性率与用药前相比．均显著性降低（P〈0．05）；对照组与米非司酮组用药后相比，差异无统计学意义（P〉0．05）；与炔诺酮组用药后相比，炔诺酮组低于对照组，差异有统计学意义（P〈0．05）。米非司酮组Hb含量升高较炔诺酮组更明显，差异有统计学意义（P〈0．05）。结论小剂量米非司酮能抑制子宫内膜单纯型增生，使子宫内膜转化为增生期内膜。小剂量米非司酮作用于单纯型增生子宫内膜，使子宫内膜ER和PR含量下降并接近正常子宫内膜增生中晚期水平。小剂量米非司酮使患者用药期间闭经，迅速改善月经过多及继发贫血的临床症状，不良反应小。

Objective To explore the effect of low-dose imfepristone on the endometrial simple hyperplasia. Methods Study group were randomly divided into two groups. 43 cases in group mifepristone,43 cases in group norethindrone and control group were 20 cases. The endometrial histopathology and the contents of ER and PR were examined before and after the treatment. The changes of endometrial thickness and hemoglobin were detected,too. Results The endometria were all simple hyperplasia before taking the medicine and turned to proliferative stage after taking mifepristone and norethindrone. There were significant difference compared with taking the medicine before（P 〈 0.05 ）. However, there were no statistical difference between two groups after taking the medicine（ P 〉 0.05）. The endometrial ER and PR were significantly depressed after taking the medicine compared with before in study group （P 〈 0.05）. There were nb significant difference between control group and group mifepristone after taking mifepristone（ P 〉 0.05）. But there were significant difference between control group and group norethindrone after taking norethindrone（ P 〈 0.05）. The endometrum were significant turned thin and the contents of hemoglobin were significantly risen up after taking the medicine in study group（ P 〈 0.05）. But the contents of hemoglobin were significantly risen up after taking the medicine in group mifepristone compared with group norethindrone （ P 〈 0.05 ）. Conclusions Low-dose mifepristone can inhibit endometrial simple hyperplasia and turn the endometria from simple hyperplasia to proliferative stage. Low-dose mifepristone may adjust the endometrial ER and PR for inhibitring endometrial hyperplasia and make the expression of endometrial ER and PR decrease. But the contents of ER and PR were more close to normal after taking mifepristone. Low-dose mifepristone can attenuate the endometria and regain the hemoglobin fast. There are seldom side-effects after taking low-dose mifepristone.