不同剂量的米非司酮治疗子宫肌瘤的疗效比较

Response of uterine leiomyoma to different dose of mifepristone

为了观察两种不同剂量的米非司酮（ＲＵ４８６）治疗子宫肌瘤的疗效，我们治疗了３３例子宫肌瘤病人，非随机分为两组进行前瞻性研究。１９例每天服用２５ｍｇＲＵ４８６（Ａ组），１４例每天服用１２．５ｍｇ（Ｂ组），都从月经第１～３天开始服药，连续用３个月，治疗前及治疗后３个月均Ｂ超观察子宫及子宫肌瘤的大小。结果：Ａ组子宫肌瘤缩小３８．６７％，子宫缩小１０．３８％，Ｂ组子宫肌瘤缩小２５．９４％，子宫缩小１２．６３％。Ａ组的肌瘤缩小较Ｂ组明显，尤其是Ａ组中的小肌瘤（最大径线３ｃｍ以内）用药后１３例有８例肌瘤消失，而Ｂ组中５例都没有消失，两组之间有显著性差异（Ｐ＜０．０５）。两组用药后均出现闭经，痛经消失。认为每天口服２５ｍｇＲＵ４８６是治疗子宫肌瘤较为理想的治疗剂量，尤其适合于那小些肌瘤的病人。

In order to observe the response of uterine leiomyoma to two different doses of mifepristone(RU486),we treated 33 women with uterine leiomyoma,prospective nonrandomized trial of them,they were divided into two groups,nineteen patients were treated with 25mg of RU486 daily and fourteen patiants were treated with 12 5mg daily for 3 months,beginning on day 1 to 3 of the menstrual cycle Size changes of leiomyoma and uterus were measured with ultrasonography before treatment and after 3 months Result:After 3 months of RU486 treatment,the size of leiomyoma and uterus respectively decreased by 10 38% and 38 67% in the 25mg daily dose group and 12 63%,25 94% in the 12 5mg daily dose group Small leiomyoma(diametre≤3cm)vanished in the 25mg daily dose group in 8 of 13 patients;but not vanished in the 12 5mg daily dose group,there was significant difference between the two treatment group Ovarian acyclicity was induced in both groups of patients after treatment with RU486,and dysmenorrhea disappeared;The side effects were slight and similar Conclusion:RU486 of 25mg daily is considered to be a more ideal dosage for treatment,it is indicated in small leiomyoma;if leiomyoma appears again,it can be treated with RU486 repeatedly