米非司酮对子宫内膜异位症患者性激素水平的影响

Effect Mifepristone on Serum Hormone Levels of Endometriosis

目的观察长期服用小剂量米非司酮对子宫内膜异位症患者性激素水平的影响。方法对300例手术确诊为子宫内膜异位症患者术后口服米非司酮治疗(25 mg,1 d一次,3个月,之后12.5 mg,1 d一次,3个月),连续服用6个月。分别于治疗前、服药3个月、6个月及停药后3个月、6个月和12个月采用荧光免疫法测定血清卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)、黄体酮(P)和催乳素(PRL)水平。观察治疗前后患者体内性激素的变化情况,了解长期服用米非司酮对激素水平的影响。结果服药后血清FSH、LH、E2和P水平较用药前下降,其中E2和P水平明显下降(P<0.05),而FSH和LH的下降变化与治疗前比较无统计学意义(P>0.05);用药后血清PRL水平无明显变化(P>0.05)。停药后3个月血清FSH、LH、E2和P水平恢复用药前水平。结论长期服用小剂量米非司酮对子宫内膜异位症患者性激素的影响是可逆的,可有效缓解症状,用药过程中出现不良反应的情况较少,安全性较高。

Objective To evaluate the effect of long term treatment with low-dose mifepristone on serum hormone levels of endometriosis. Methods Three hundred women diagnosed endometriosis with clinical symptoms were studied. Mifepristone was administered 25 mg daily for 3 months and 10 mg daily for another 3 months. Clinical symptoms were assessed before, during, and after treatment. Serum level of follicle-stimulating hormone （ FSH ） , luteotrophic hormone （LH） , estradiol （ E2 ） , progesterone （P） and prolactin（PRL） were determined for 3 months and 6 months, and 3 to 12 months after and before treatment. All the cases were made 1 year follow-up to evaluate the effect and side-effect of mifepristone. Results Serum level of E2 and P decreased during the treatment （P 〈 0.05）. FSH and LH level also decreased compared with condition before treatment but there were no statistic significance （P 〉 0.05 ）. There was no significant changing of serum level of PRL（P 〉 0.05 ）. Conclusion The effect of long term treatment with low-dose mifepristone on serum hormone levels of endometriosis appears to be reversible. Mifepristone is effective in improving the symptoms and with less significant side effects.