米非司酮联合甲氨蝶呤治疗异位妊娠的临床研究

Clinical effect of mifepristone combined with methotrexate in the treatment of ectopic pregnancy

目的评价米非司酮联合甲氨蝶呤治疗异位妊娠的临床疗效和安全性。方法入选60例异位妊娠的孕妇随机分为试验组和对照组,每组30例,试验组口服米非司酮100 mg,每天1次,联合肌肉注射甲氨蝶呤50 mg·m^(-2);对照组肌肉注射甲氨蝶呤50 mg·m^(-2),疗程为2周。观察比较2组患者血β-人绒毛膜促性腺激素(β-HCG)值、恢复时间、附件包块直径及不良反应。结果治疗2周后,2组患者血清内β-HCG与治疗前明显下降,平均包块直径也均明显减小(P<0.05);试验组降低程度明显优于对照组。试验组有效率为92.5%,高于对照组的72.5%(P<0.05)。试验组胃肠道反应发生率明显低于对照组(P<0.05)。结论米非司酮联合甲氨蝶呤治疗异位妊娠的临床疗效明显优于单用甲氨蝶呤,不良反应发生率低。

Objective To explore the clinical efficacy and safety of mifepristone combined with methotrexate in the treatment of ectopic preg- nancy. Methods A total of 60 cases of ectopic pregnancy pregnant women were randomized divided into trial group and control group, 30 cases in each group. Trial group was treated with methotrexate 50 mg·m 2, and mifepristone 100mg, once a day; while the control group was treated with methotrexate 50 mg · m-2. The course of treatment was two weeks. The level of β-human chorionic gonadotrophin （HCG） value, recovery time, accessory mass piece diameter and adverse drug reactions were recorded and compared. Results After 2 weeks treatment, serum 13 - HCG of all patients significantly decreased, the average diameter wrapped piece significantly decreased compared with that before treatment （ P 〈 0.05 ） in two groups. The extent of trial group was significantly bet- ter than that of control group. Total effective rate of trial group was 92.5%, higher than that of control group 72.5% （P 〈 0.05 ）. The rate of adverse drug reactions with gastrointestinal in trail group was significantly lower than that of control group （ P 〈 0.05 ）. Conclusion Mifepristone combined methotrexate for ectopic pregnancy has better clinical efficacy and less adverse drug reactions than methotrexate alone.