米非司酮片对子宫内膜异位症患者术后复发及血清VEGF的影响

Influence of mifepristone tablets on recurrence and serum VEGF of endometriosis patients after operation

目的探讨米非司酮片预防子宫内膜异位症(endometriosis,EM)术后复发的临床疗效,及对性激素(LH、FSH、E2、P)和血管内皮生长因子(Vascular Endothelial Growth Factor,VEGF)水平的影响。方法选择子宫内膜异位症术后患者60例,随机分为治疗组和观察组,每组各30例。治疗组于术后月经第1天开始口服米非司酮片12.5 mg/次,日1次,疗程为6个月;观察组术后不用药治疗;两组术后随访12个月。观察两组术后复发率、妊娠率,术后3 d、6个月、12个月血清性激素和VEGF水平和不良反应发生情况。选取30例健康体检妇女为对照组,检测血清性激素、VEGF水平做参照。结果 1治疗组、观察组的总有效率分别为93.3%和76.7%(P<0.05),治疗组的复发率低于对照组(P<0.05)。2EM患者术后3天血LH、E2、P和VEGF水平高于对照组(P<0.01)。3治疗组三个时点血LH、E2、P和VEGF水平变化显著(P<0.05或P<0.01),观察组三个时点血LH、E2、P和VEGF水平变化不显著,两组间差异有统计学意义(P<0.01)。4随访期间治疗组、对照组分别有7例(23.3%)、3例(10%)受孕。结论米非司酮片预防子宫内膜异位症术后复发的临床疗效显著,其作用机制之一可能是通过调节血清性激素、VEGF水平而实现。

Objective To investigate the clinical efficacy of mifepristone tablets in preventingrecurrence of endometriosis（ EM）,and its impact on levels of sex hormones（ LH、FSH、E2、P） and vascular endothelial growth factor（ VEGF）. Methods 60 cases of endometriosis patients were randomly divided into the treatment group and the observation group,30 cases in each group. The treatment group began to take mifepristone tablets12. 5mg daily at the first day of menstruation after operation,the treatment lasted for six months. Patients in the observation group without drugs after the operation. Patients in both groups were followed up for 12 months.Recurrence rate,pregnancy rate,serum sex hormones（ LH,FSH,E2,P） VEGF levels at 3d,6 months and 12 months postoperativeand adverse events of two groups were observed. 30 healthy women were selected as the control group,serum sex hormone and VEGF levels were observed to make reference. Results The total efficiency of the treatment group and the observation group were 93. 3% and 76. 7%（ P〈0. 05）,the recurrence rate of treatment group was lower than the control group（ P〈0. 05）. Blood LH,E2,P and VEGF levels of EM patient were higher than the control group3 days postoperative（ P〈0. 01）. Blood LH,E2,P and VEGF levels changed significantly at the three timepoints in the treatment group（ P〈0. 05 or P〈0. 01）,however,LH,E2,P and VEGF levels did not change significantly in the observation group,the differencesbetween the two groups were statistically significant（ P〈0. 01）. During follow-up period,7 cases（ 23. 3%） in the treatment group and 3cases（ 10%） in the observation group got pregnancy. Conclusions The clinical efficacy of mifepristone tablets in preventing recurrence of endometriosis is significant,one of the mechanisms probably by regulating serum sex hormone and VEGF levels achieved.