不同剂量米非司酮治疗对子宫肌瘤患者临床疗效、激素水平和血管内皮生长因子的影响

The effects of different doses of mifepristone on clinical efficacy hormone levels and vascular endothelial growth factor in patients with hysteromyoma

目的探讨不同剂量米非司酮治疗对子宫肌瘤患者临床疗效、激素水平和血管内皮生长因子(vascular endothelial growth factor,VEGF)的影响。方法2018年1月至2021年1月在我院进行治疗的138例子宫肌瘤患者,设为A组70例(大剂量24 mg米非司酮治疗)、B组68例(小剂量12 mg米非司酮治疗)。对比两组治疗后临床疗效、治疗前后激素水平、VEGF水平变化及不良反应情况,应用腹部B超复查,观察子宫体积、子宫肌瘤体积变化。结果两组患者总有效率比较差异无统计学意义(P>0.05);治疗后两组FSH、LH、E2、P水平均明显下降,且B组下降幅度大于A组(P<0.05);两组VEGF、VEGFR-2水平均明显降低,B组VEGF、VEGFR-2水平显著低于A组(P<0.05);两组患者子宫平均体积、子宫肌瘤平均体积均显著缩小,B组缩小面积明显大于A组(P<0.05);A组不良反应总发生率17.14%,显著高于B组5.88%(P<0.05)。结论两种剂量米非司酮治疗子宫肌瘤均效果均较佳,但小剂量米非司酮治疗更有利于抑制患者激素水平及血管内皮生长因子表达,且安全性更高。

Objective To explore the effects of different doses of mifepristone on clinical efficacy,hormone levels and vascular endothelial growth factors(VEGF)of patients with hysteromyoma.Methods One hundred and thirty-eight patients with uterine fibroids treated in our hospital from January 2018 to January 2021 were selected.The patients were divided into group A(n=70 treated with high-dose 24 mg mifepristone)and group B(n=68 treated with low dose 12 m mifepristone).The clinical efficacy,changes in hormone levels and VEGF levels before and after treatment as well as adverse reactions of the treatment were compared between the two groups.Abdominal B-ultrasound was used for re-examination to observe changes in uterine volume and volume of hysteromyoma.Results There was no significant difference in the total effective rate between the two groups(P>0.05).The levels of FSH,LH,E2,and P of the patients were decreased significantly after both groups were treated,and the decrease in the group B was greater than that in the group A(P<0.05).The levels of VEGF and VEGFR-2 in the two groups were significantly reduced.The levels of VEGF and VEGFR-2 in the group B were significantly lower than those in the group A(P<0.05).The average volume of the uterus and the average volume of hysteromyoma in the two groups were significantly reduced.The reduced area in the group B was significantly larger than that in the group A(P<0.05).The total incidence of adverse reactions in the group A was 17.14%after treatment,which was significantly higher than 5.88%in the group B(P<0.05).Conclusion Both doses of mifepristone have good therapeutic effects in the treatment of hysteromyoma,but a small dose of mifepristone is more conducive to inhibiting the patient's hormone levels and VEGF expression.A lower dose of mifepristone also has a higher safety level.