米非司酮抗糖皮质激素作用对垂体-肾上腺轴的影响

Effect of Anti-glucocorticoid Action of Mifepristone on the Pituitary Adrenal Axis

6名早孕妇女用米非司酮合并前列腺素终止妊娠过程中,测定了血皮质醇、皮质酮、醛固酮和ACTH的变化,与6名健康者进行了对比。结果:皮质醇、皮质酮和ACTH服药后2～4h上升,24h时达峰值,以后逐渐回复至给药前水平。提示:米非司酮终止妊娠过程中,垂体-肾上腺功能发生急性代偿性变化。推论与米非司酮拮抗了糖皮质激素对丘脑下部-腺垂体的负反馈机制有关。

6 pregnant women (below 49 days of amenorrhea) received 600mg mifepristone orally in a single dosage and 1 mg PG-05 or ONO-802 as vaginal suppository 48 hrs afterward.Plasma cortisol,corticosterone,aldosterone and ACTH were monitored at-1/2,1,2,4,10,24,48,72 hrs and a follow-up visit was made on 8th day Cortisol increased during the treatment and the values returned to the pretreatment level on the first follow-up visit.The changes of corticosterone were similar to those of cortisol.ACTH was also elevated within first 2 hrs and returned to the basal level at 48 hrs.There was no significant change in aldosterone during the treatment.The above results,suggest that a compensation of the pituitary-adrenal function occurred during the treatment,which is probably associated with decreased negative feedback mechanism of cortisol at the hypothalamus level due to the antiglucocorticoid activity of mifepristone.