药物流产对女性生殖激素的影响

目的探讨米非司酮对早孕妇女生殖激素的影响。方法选择自愿要求终止妊娠的早孕妇女为研究对象,随机分为药物流产组(204例)和人工流产组(200例),取2组人群外周血,药流组于口服米非司酮前、后及流产后14 d、22 d,人流组于术前及术后14 d、22 d,测定雌二醇(E2)、促黄体生成素(FSH)、促卵泡生成素(LH)、孕酮(P)和人绒毛膜促性腺激素(β-HCG)水平。结果药流组服药后E2明显上升,差异有统计学意义(P<0.05);P无明显变化,差异无统计学意义;β-HCG呈上升趋势,但弱于人流组;2组FSH均下降,差异有统计学意义(P<0.05);LH无显著性变化,差异无统计学意义。流产后第14、22天2组E2均呈上升趋势,但是药流组较同期人流组,E2升高缓慢,差异有统计学意义(P<0.05);药流组β-HCG下降趋势较人流组平缓,差异有统计学意义(P<0.05);药流组P水平始终高于人流组,差异有统计学意义(P<0.05);2组FSH呈波动状态,LH均呈下降趋势,差异无统计学意义。结论米非司酮对早孕妇女生殖激素水平确有影响。尤其当药流后阴道流血超过10 d时,应检测血清E2、P、HCG水平,出现E2低于卵泡期水平,P高于卵泡期水平,HCG下降缓慢,提示不全流产,应及时清宫。

Objective To study the effects of Mifepristone on early-pregnant women through examining the levels of human choionic gonadotophin(β-HCG), follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), progesterone (P) and prolactin (PRL) in women of early pregnancy before,after taking Mifepristone and after abortion. Methods Women of early pregnancy who visited the clinic to opt for voluntary termination of their pregnancy were selected as target population for the study, and they were randomly divided into the medicaments abortion group (n=204)and the artificial abortion group (n=200). Peripheral blood samples were drawn from the medicaments abortion group before and after taking Mifepristone and 14 days and 22 days after abortion. Peripheral blood samples were also drawn from the artificial abortion group before and 14 days and 22 days after abortion. The blood samples were tested for levels of estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH), progesterone (P) and of human choionic gonadotophin (β-HCG). Results After taking Mifepristone, the E2 level of the medicaments abortion group rose significantly, with significant difference (P<0.05); there was no significant change in its P level, with no significant difference and the β-HCG level appeared to be on the rise, but lower than that of the artificial abortion group. The FSH levels of both groups were lower (P<0.05), LH showed no significant change. On the 14 th day and 22 th day after abortion, the E2 levels of both groups appeared on the rise, but E2 level of the medicaments abortion group rose slower than that of the artificial abortion group in the same period (P<0.05).The β-HCG level of the medicaments abortion group declined more gently than that of the artificial abortion group. The P level of the medicaments abortion group maintained higher than that of the artificial abortion group throughout (P<0.05). The FSH levels of both groups appeared to fluctuate, and the LH levelsof both groups appeared to decline with no significant difference. Conclusion Mifepristone does affect the levels of reproductive hormone in women of earlypregnancy. The E2, P and HCG levels of blood serum should be tested, especially when vaginal bleeding after medicaments abortion is more than 10 d. When E2level and P level are both lower than that of the follicular phase, and HCG level declines gradually, indicative of incomplete abortion, timely actions should be taken to clean the uterus.