不同剂量米非司酮治疗子宫肌瘤122例疗效分析

Different doses of mifepristone treatment of 122 cases of uterine myoma Effect Analysis

目的观察不同剂量米非司酮治疗子宫肌瘤的临床疗效和安全性。方法将122例确诊子宫肌瘤的患者分为3组,A组应用米非司酮5mg/d,B组应用米非司酮12.5mg/d,C组应用米非司酮25mg/d;月经第1天始服用,连服3个月为1疗程。用药前、用药后B超测量子宫及子宫肌瘤的三维径线;用药前和用药3个月后测定促卵泡激素(FSH)、黄体生成素(LH)、雌二醇(E2)、孕酮(P),检测血常规、肝肾功能,观察服药的不良反应。结果3组患者治疗期间均闭经,血红蛋白上升,3组子宫及肌瘤体积均明显减小,A组子宫缩小22.7%(P<0.01),B组子宫缩小24.9%(P<0.01),C组子宫缩小26.4%(P<0.01),A组最大肌瘤体积比用药前缩小26.9%(P<0.15)。B组最大肌瘤体积平均比用药前缩小28.8%(P<0.01)。C组肌瘤体积平均缩比用药前缩小30.65%(P<0.01)。各组治疗前后对比,差异有统计学意义(P<0.01);促卵泡激素(FSH)、黄体生成素(LH)、雌二醇(E2)和孕酮(P)用药前后对比,平均水平均下降,差异有统计学意义(P<0.01)。结论小剂量米非司酮治疗子宫肌瘤疗效好,不良反应轻,为保守治疗子宫肌瘤提供了一条新的治疗途径。

Objective To observe the different doses of mifepristone for treatment of uterine fibroids clinical efficacy and safety. Methods 122 cases of patients with diagnosed uterine leiomyoma were divided into 3 groups, A group of application of mifepristone 5 mg / d, B group, mifepristone 12. 5 mg/ d, C group, mife- pristone 25 mg/ d; period before the 1 st day using it, even for 3 months to 1 course of treatment. Medication before the medication after the B-measurement of the uterus and uterine myoma diameter line three-dimensional; medication use before and three months after determination of follicle-stimulating hormone （FSH） , luteinizing hormone （ LH）, estradiol （ E2 ）, progesterone （ P）, detection of blood, liver and kidney function, medication side effects observed. Results 3 groups of patients with amenorrhea during treatment, hemoglobin increased 3 uterine and fibroid volume were significantly reduced, A group of the uterus to reduce 22. 7% （P 〈0. 01 ）, B group of the uterus to reduce 24.9% （ P 〈 0. 01 ）, C Group to reduce the uterus 26.4% （ P 〈 0. 01 ）, A group of the largest fibroid volume ratio before treatment to reduce 26. 9% （ P 〈 0. 15 ）. B Group the largest myoma volume before treatment to reduce the average 28. 8% （P 〈 0.01 ）. C group Fibroid volume reduction than the average pre-medication to reduce 30. 65% （P 〈 0.01 ）. Compared before and after treatment in each group, the difference was statistically significant （P 〈 0. 01 ）; follicle-stimulating hormone （FSH）, luteinizing hormone （LH）, estradiol （E2） and progesterone （P） before and after contrast administration, the average water dropped by an average, the difference was statistically significant （P 〈 0.01 ）. Conclusion Low-dose efficacy of mifepristone treatment of uterine fibroids, and adverse effects of light, for the conservative treatment of uterine fibroids provides a new way of treatment.