米非司酮联合甲氨蝶呤在异位妊娠治疗中的效果和安全性观察

Efficacy and safety of mifepristone combined with methotrexate in the treatment of ectopic pregnancy

目的:观察米非司酮联合甲氨蝶呤在异位妊娠治疗中的效果和安全性。方法:选取2014年6月至2016年6月期间海南医学院第二附属医院妇科收治的400例异位妊娠患者为研究对象,按随机数字法分为观察组和对照组。对照组采用甲氨蝶呤治疗,观察组采用米非司酮联合甲氨蝶呤治疗。治疗前、后,观察患者血β-HCG、血孕酮及包块直径变化,并统计患者的临床疗效及不良反应发生情况。结果:治疗前,2组患者的血β-HCG、血孕酮含量及包块直径无明显差别(P>0.05);治疗后,2组患者的血β-HCG、血孕酮含量及包块直径明显降低,且观察组的血β-HCG(1252±87.62)IU/L、血孕酮(4.53±1.13)U/L及包块直径(1.52±0.22)cm明显低于对照组血β-HCG(1367.84±93.47)IU/L、血孕酮(7.12±1.06)U/L及包块直径(2.17±0.24)cm,差异具有统计学差异(P<0.05)。治疗后,观察组的有效率88.50%(177/200)明显高于对照组有效率81.50%(163/200),两组之间的差异有统计学意义(P<0.05)。观察组的不良反应发生率21.50%(43/200)与对照组不良反应发生率22.50%(45/200)比较,其差异无统计学意义(χ~2=4.24,P=0.107)。结论:采用米非司酮联合甲氨蝶呤治疗异位妊娠患者,改善患者的血孕酮及血β-HCG含量,明显降低包块直径,提高患者的临床疗效,值得临床借鉴。

Objective： To observe the efficacy and safety of mifepristone combined with methotrexate in the treatment of ectopic pregnancy. Methods： 400 patients with ectopic pregnancy treated in our hospital from June 2014 to June 2016 were divided into the observation group and control group by random number method. The control group was treated with methotrexate,and the observation group was treated with mifepristone combined with methotrexate. Before and after treatment,the serum β-HCG,serum progesterone and the diameter of the mass were observed,and the clinical efficacy and adverse reactions were analyzed. Results： Before treatment,the serum β-HCG,progesterone and mass diameter had no significant difference between the two groups（ P〉0. 05）,while the serum β-HCG,progesterone and mass diameter decreased significantly in the two groups after treatment. The serumβ-HCG（ 1252 ± 87. 62） IU/L,progesterone（ 4. 53 ± 1. 13） U/L and mass diameter（ 1. 52 ± 0. 22） cm in the observation group was significantly lower than the control group,which were（ 1367. 84 ± 93. 47） IU/L,（ 7. 12 ±1. 06） U/L and（ 2. 17 ± 0. 24） cm respectively,with statistically significant differences（ P〈0. 05）. After treatment,the effective rate of the observation group was 88. 50%（ 177/200）,significantly higher than that of the control group of 81. 50%（ 163/200）,with statistically significant difference（ P〈0. 05）. The incidence of adverse reactions was 21. 50%（ 43/200） in the observation group and 22. 50%（ 45/200） in the control group,without significant difference（ χ~2= 4. 24,P = 0. 107）. Conclusions： Mifepristone combined with methotrexate can improve the serum progesterone and β-HCG while significantly reduce the mass diameter in the treatment of ectopic pregnancy,hereby improving the clinical efficacy and worth promotion.