不同剂量米非司酮治疗围绝经期功能性子宫出血临床观察

Clinical Observation of Different Doses of Mifepristone in Treatment of Perimenopausal Dysfunctional Uterine Bleeding

目的:对不同剂量米非司酮在围绝经期功能性子宫出血中的疗效进行观察,从而确定治疗围绝经期功能性子宫出血的最小有效剂量。方法:将90例围绝经期功能性子宫出血患者随机分为A、B、C三组,每组30例,确定治疗剂量A组10mg,B组15mg,C组20mg,口服,每天1次,连续口服满3个月为一个疗程。比较治疗前后三组的性激素水平,并对治疗前后三组患者的子宫大小及内膜厚度变化进行比较。结果:A组复发率为23.33%,闭经率为50.00%,均明显高于B、C两组;在接受药物治疗后,三组的促卵泡生成素(FSH)、黄体生成素(LH)、孕酮(P)水平及子宫内膜厚度均明显低于治疗前(P<0.05);对于雌二醇(E)水平,A组高于B、C两组(P<0.05)。结论:根据最小有效剂量的治疗原则,中间量15mg,每天1次,连续口服3个月治疗围绝经期功能性子宫出血的方案最为合适。

Objective ： To observe the effects of different doses of mifepristone in perimenopausal dysfunctional uterine bleeding, to determine the minimum effective dose of perimenopausal dysfunctional uterine bleeding. Method： 90 cases of perimenopausal dysfunctional uterine bleeding were randomly divided into A, B, C three group, each group of 30 patients, determine the therapeutic dose of A group 10 mg, group B 15 mg, group C 20 mg, persuade its to orally, once a day, orally for 3 months as a course. Comparison of before and after treatment in three groups of patients with sex hormone levels, and the three groups before and after treatment in patients with uterine size and endometrial thickness were compared. Result： The recurrence rate in A group was 23.33%, the amenorrhea rate of 50%, higher than the B, C in two groups; after receiving medical treatment, three groups of folliclestimulating hormone （ FSH ）, luteinizing hormone （ LH ）, progesterone （ P ） levels and endometrial thickness were significantly lower than those before therapy （ P〈0.05 ） ; the level of estradiol （ E ）, A group was higher than that of B, C two group （ P〈0.05 ） . Conclusion： According to the minimum effective dose of therapeutic principles, intermediate quantity 15mg, once a day, continuous oral administration of 3 months of treatment of perimenopausal dysfunctional uterine bleeding a plan most suitable.