米非司酮对FUB的治疗效果及Ang-2和VEGF的影响

Therapeutic effect of mifepristone on functional uterine bleeding in perimenopausal period and its effects on Ang2 and VEGF

目的探讨米非司酮治疗围绝经期功能性子宫出血(FUB)的临床疗效及对患者血浆中血管生成素2(Ang-2)、血管内皮生长因子(VEGF)的影响。方法选取2014年1月至2016年1月山东大学附属省立医院收治的刮宫后FUB患者110例,随机分为实验组和对照组各55例,实验组使用米非司酮治疗,对照组采用去氧孕烯炔雌醇片治疗,疗程90天,观察两组治疗效果。结果治疗后实验组患者的血促卵泡生成素(FSH)、黄体生成素(LH)、雌二醇(E2)、孕酮(P)水平显著低于对照组,差异具有统计学意义(t值分别为5.063、3.987、5.478、4.398,均P<0.05);治疗后实验组患者的子宫内膜厚度显著薄于对照组,差异具有统计学意义(t=9.392,P<0.05);治疗后实验组患者的Ang-2水平显著低于对照组,差异具有统计学意义(t=4.267,P<0.05);实验组的VEGF水平显著高于对照组,差异具有统计学意义(t=3.827,P<0.05);实验组患者的痊愈率为85.45%、有效率为12.73%、无效率为1.82%,对照组痊愈率为69.09%、有效率为25.45%、无效率为5.45%,差异具有统计学意义(Z=-2.058,P<0.05)。结论米非司酮治疗FUB患者的临床疗效优于去氧孕烯炔雌醇片,能更有效地调节Ang-2、VEGF及激素水平。

Objective To discuss the clinical efficacy of mifepristone on treating functional uterine bleeding （FUB） in perimenopausal period and its effect on angiopoietin 2 （Ang2） and vascular endothelial growth factor （VEGF） in plasma. Methods Total 115 patients with FUB after dilatation and curettage admitted in Provincial Hospital Affiliated to Shandong University during January 2014 to January 2016 were selected and divided into experimental group （57 cases） and control group （58 cases） randomly. In the experimental group, the patients were treated with mifepristone while in the control group the patients were treated with desogestrel and ethinylestradiol tablets. The therapeutic effects of the two groups were observed after 90-day course. Results After treatment, the levels of serum Follicle-Stimulating Hormone （FSH）, luteinizing hormone （LH）, estrogen （E2） and progestone （P） of the patients in the experimental group were significantly lower than those of patients in the control group, and the differences were statistically significant （t value was 5.063, 3.987, 5.478 and 4.398, respectively, all P〈0.05）. After treatment, the endometrial thickness of patients in the experimental group was significantly thinner than that of patients in the control group, and the differences were statistically significant （t = 9. 392, P〈0.05）. After treatment, the Ang-2 level of patients in the experimental group was significantly lower than that of patients in the control group, and the difference was statistically significant （t=4.267, P〈0.05）. The VEGF level in the experimental group was significantly higher than that in the control group, and the difference was statistically significant （t=3.827, P 〈0.05）. In the experimental group, the cure rate was 85.45 %, the effective rate was 12.73%, and the inefficiency rate was 1.82%, while in the control group, they were 69.09%, 25.45% and 5.45%, resepctively. The differences were statistically significant （Z =- 2.058, P〈0.05）.Conclusion The clinical efficacy of mifepristone in treatment of FUB is better than that of desogestrel and ethinylestradiol tablets, and it can regulate hormone levels and Ang-2 and VEGF levels more effectively.