RU_(486)对早孕妇女蜕膜组织甾体激素受体及内分泌的影响

Effect of mifepristone on steroid receptors and endocrine in human decidua of early pregnant women

目的 了解米非司酮及米索对人早孕蜕膜雌激素受体(ER)、孕激素受体(PR)的表达及血清内分泌水平的影响。方法 取正常早孕、服用米非司酮及服米非司酮配伍米索后各20例的蜕膜,应用单克隆抗体链霉素亲生物蛋白——过氧化酶 (SP) 免疫组织化学方法测定 ER、PR 的表达及血清激素水平的变化。结果米非司酮配伍米索使蜕膜组织中 ER、PR 表达下调,正常早孕组、服米非司酮组及服米非司酮配伍米索组之间差异有显著性。血清雌二醇(E_2)、睾酮(T)、泌乳素(PRL)含量上升,孕酮(P)下降;而对 FSH、hCG 的含量无明显影响。结论 大剂量RU_(486)能竞争地结合蜕膜组织孕激素受体,使早孕期高浓度的内源性孕酮与其受体的正常结合受到干扰,从而达到抗早孕的目的。

Objective To investigate the effects of mifepristone ( RL486) and misoprostol on decidua of early pregnancy at the cellular level of estrogen receptor (ER) and progesterone receptor (PR) and hormone level in serum. Methods Sixty specimens of deciduas were obtained from early pregnant women with 6-7 weeks duration,of which 20 were normal pregnancy,20 were treated with mifepristone and 20 mifepristone plus misoprostol respectively. The level of ER and PR in decidua and hormone level in serum were compared among three groups by unmunohistochemistry and radioimmunoassay. Results The ER and PR level in human deciduas decreased after mifepristone plus misoprostol treatment. There were significant differences of the level of ER and PR among the three groups. In the group treated with mifepristone plus misoprostol,the concentrations of estradiol,testosterone and prolactin in serum were increased,while progesterone was decreased,but the level of follicular-stimulating hormone (FSH) and human chorionic gonadotropin (HCG) were not obviously affected. Conduskms Large doses of mifepristone competitively bind with progesterone receptor in decidua,which inteferes the combination of endogenous high-concentrated progesterone with its receptor in early pregnancy,so that the effect of terminating early pregnancy by mifepristone can be achieved.