米非司酮对拟行子宫肌瘤切除术患者相关指标的影响

Effects of Mifepristone on Related Indexes of Patients with Myomectomy

目的:探讨米非司酮对拟行子宫肌瘤切除术患者相关指标的影响。方法:回顾性分析100例子宫肌瘤患者的资料,按照治疗方式不同分为观察组和对照组,每组50例。对照组患者仅给予单纯子宫肌瘤切除术治疗;观察组患者术前3个月于月经第1天起,每晚给予米非司酮片10 mg,每天1次,口服,连续服用3个月,停药后2 d内实施子宫肌瘤切除术,术后继续给予米非司酮片10 mg/d,口服,连续服用3个月。两组均随访6个月。比较两组患者最大子宫肌瘤体积和子宫体积、相关手术指标、血清生殖激素水平、子宫肌瘤组织性激素水平和相关生长因子受体水平等指标,记录复发情况和不良反应发生情况。结果:手术前,观察组患者最大子宫肌瘤体积和子宫体积均显著小于对照组,差异均有统计学意义(P<0.05);观察组患者手术时间、术后阴道出血时间和住院时间均显著短于对照组,术中出血量显著少于对照组,复发率显著低于对照组,差异均有统计学意义(P<0.05);术后6个月,观察组患者雌激素受体(ER)、孕激素受体(PR)、子宫肌瘤组织表皮生长因子受体(EGFR)、转化生长因子β1受体(TGF-β_1R)、胰岛素样生长因子受体(IGF-1R)表达水平均显著低于对照组,差异均有统计学意义(P<0.05);两组患者初诊时和术后6个月后血清促卵泡激素(FSH)、雌二醇(E_2)、孕酮(P)水平比较,差异均无统计学意义(P>0.05)。治疗期间两组患者均未见明显不良反应发生。结论:对拟行手术切除的子宫肌瘤患者,米非司酮有助于减少手术时间、术中出血量、术后阴道出血时间和住院时间,预防术后复发,这可能与其调节ER、PR和相关生长因子受体水平有关。

OBJECTIVE： To study the effects of mifepristone on related indexes of patients with myomectomy. METHODS： The information of 100 patients with uterine fibroids were analyzed retrospectively, and they were divided into observation group and control group according to therapy method, with 50 cases in each group. Control group only received myomectomy. Observation group was given Mifepristone tablets 10 mg orally, qd, for consecutive 3 months, and then received myomectomy within 2 d after drug withdrawal; they were given Mifepristone tablets 10 mg/d orally after surgery, for consecutive 3 months. The 2 groups were followed up for 6 months. The maximual volume of uterine fibroids and the volume of uterus were compared between 2 groups as well as related operation indicator, levels of serun reproductive hormones, sex hormones of uterine myoma tissure and related growth factors of uterus myomas. The recurrence and occurrence of ADR was recorded during treatment. RESULTS： Before surgery, the maximual volume of uterine fibroids and the volume of uterus in observation group were significantly lower than control group, with statistical significance（P〈0.05）. The operation time, vaginal bleeding time and hospital stay of observation group were significantly shorter than those of control group, the intraoperative blood loss and the recurrence rate were significantly lower than those of control group, with statistical significance （P〈0.05）. Six months after surgery, ER, PR, EGFR, TGF-13~R and IGF-1R of uterus myomas in observation group were significantly lower than those of control group, with statistical significance （P〈0.05）. There was no statistical significance in the levels of FSH,E2 and P level of uterus myomas between 2 groups in first diagnosis and 6 months after surgery（P〉0.05）. No obvious ADR was found in 2 groups during treatment. CONCLUSIONS： Mifepristone helps to reduce operative time, intraoperative blood loss, vaginal bleeding time and hospital stay of patients with myomectomy, and may be related to the regulation of ER and PR levels and related growth factor receptors.