米非司酮治疗围绝经期功能失调性子宫出血128例临床观察

Clinical observation of mifepristone in the treatment of perimenopausal dysfunctional uterine bleeding in 128 cases

目的观察围绝经期功能失调性子宫出血应用米非司酮治疗的临床疗效。方法选取本院2009年5月～2012年10月收治的128例围绝经期功能失调性子宫出血患者作为研究对象,所有患者均给予米非司酮口服10mg口服,1次/d,以连续治疗30d为1个疗程,连续治疗2个疗程,观察治疗效果。结果本组128例患者治愈79例,有效33例,无效16例,总有效率为87.5%。治疗1个月后血浆卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)、孕酮(P)、血红蛋白及子宫内膜厚度等各项指标均较治疗前有所改善(P<0.05),但治疗2个月后改善水平更加明显,差异具有统计学意义(P<0.01)。本组患者服药期间4例患者出现轻微恶心、呕吐,2例患者出现头昏,给予适当减量处理后消失,未影响持续治疗。结论围绝经期功能失调性子宫出血应用米非司酮治疗效果理想,且安全性较高,值得推广应用。

Objective To observe the clinical effects of mifepristone in the treatment of perimenopausal dysfunctional uterine bleeding. Methods One hundred and twenty-eight patients with perimenopausal dysfunctional uterine bleeding treated in our hospital from May 2009 to October 2012 were selected. All patients were provided with mifepristone for oral administration （10 mg each time, once per day）. One treatment course lasted for 30 days and the therapeutic ef- fects were observed after 2 consecutive courses. Results Among all cases, the number of cure, effectiveness, and inef- fectiveness was 79, 33, and 16 cases. The total effective rate accounted for 87.5%. After 1-month treatment, the indi- cators like follicle-stimulating hormone （FSH）, luteinizing hormone （LH）, estradiol （F2）, progesterone （P）, hemoglobin and endometrial thickness were improved compared with those before treatment （P 〈 0.05）. After 2-month treatment, those indicators changed better （P 〈 0.01）. They displayed statistical differences in comparison of prior treatment. Dur- ing the courses, 4 patients presented with slight nausea and vomiting, and 2 occurred dizziness, which were disap- peared after appropriately reducing the dosage of mifepristone and didn＇t influence on the continuing treatment. Con- clusion Application of mifepristone in the treatment of perimenopausal dysfunctional uterine bleeding gets an optimum effect. It is safe and worthy of extension in clinic.