米非司酮在围绝经期功能失调性子宫出血治疗中的应用

Application of mifepristone in the treatment of perimenopausal dysfunctional uterine bleeding

目的 寻找有效治疗围绝经期功能失调性子宫出血（功血）的方法。方法 136例围绝经期功血患者应用小剂量米非司酮进行治疗,治疗前后检查患者血红蛋白、子宫内膜厚度、性激素水平,包括孕激素（P）、雌激素（E2）、卵泡生成素（FSH）、黄体生成激素（LH）、睾酮（T）、催乳激素（PRL）。结果 该疗法有效率89.7%;89例服药1个疗程后经量减少,恢复正常月经周期;33例服药1个疗程后进入绝经期。治疗后患者血红蛋白水平比治疗前显著升高（t=3.899,P＜0.05）,而子宫内膜厚度显著降低（t=5.652,P＜0.05）。治疗后患者P、E2、FSH、LH水平比治疗前均显著降低（t=5.320、4.309、3.872、3.641,均P＜0.05）,治疗前后患者T、PRL水平差异无统计学意义。结论 米非司酮治疗围绝经期功血具有良好的临床疗效,可有效止血闭经或调节月经,不良反应小,值得临床推广应用。

Objective To explore an effective treatment for perimenopausal dysfunctional uterine bleeding.Methods 136 patients with perimenopausal dysfunctional uterine bleeding were received mifepristone treatment.Hemoglobin,thickness of the endometrium and sex hormones indicators,including progesterone（P）,estrogen（E2）,the corpus luteum generated hormone（LH）,follicle hormone（FSH）,prolactin（PRL） and testosterone（T）,were detected before and after treatment.Results The treatment effective rate was 89.7%.After taking a course of treatment,89 cases decreased to restore normal menstrual cycle;33 cases entered menopause after taking a course of treatment.After treatment,hemoglobin level was significantly increased compared with before treatment（t=3.899,P〈0.05）,and endometrial thickness significantly reduced（t=5.652,P〈0.05）.After treatment,the P,E2,FSH,LH levels were significantly lower than before treatment（t=5.320,4.309,3.872,3.641,all P〈0.05）.T,PRL levels had no significant differences.Conclusion The mifepristone treatment for perimenopausal uterine bleeding have good clinical efficacy,less adverse reactions,and worthy of clinical application.