甲氨蝶呤联合米非司酮治疗异位妊娠的效果及 安全性

Clinical effects and safety of methotrexate combined with mifepristone in treatment of ectopic pregnancy

目的探讨甲氨蝶呤联合米非司酮治疗异位妊娠患者的临床疗效及对血清人绒毛膜促性腺激素(β-HCG)和不良反应的影响。方法选取2019年3月至2021年3月收治的90例异位妊娠患者,采用随机数字表法分为研究组和对照组,每组45例。对照组给予甲氨蝶呤治疗,研究组给予甲氨蝶呤联合米非司酮治疗,比较2组疗效、血清β-HCG水平与不良反应情况。结果研究组总有效率为95.56%高于对照组的77.78%(P<0.05)。治疗后,2组血清β-HCG水平均较治疗前降低,且研究组显著低于对照组(P<0.05)。治疗后,2组患者FSH、E2、LH、T水平显著改善(P<0.05),且研究组的FSH、E2、LH、T水平显著优于对照组(P<0.05)。研究组总不良反应率为20.00%,对照组总不良反应率为11.11%,2组比较差异无统计学意义(P>0.05)。结论甲氨蝶呤联合米非司酮治疗异位妊娠,可降低血清β-HCG水平,促进异位妊娠包块吸收,且并未增加不良反应,安全可靠。

Objective To investigate the clinical effects and safety of methotrexate combined with mifepristone in treatment of ectopic pregnancy,and to observe their effects on the serum levels of human chorionic gonadotropin(β-HCG)and adverse reactions in patients with ectopic pregnancy.Methods A total of 90 patients with ectopic pregnancy who were treated in our hospital from March 2019 to March 2021 were enrolled in the study,who were randomly divided into two groups,with 45 patients in each group.The patients in control group were treated by methotrexate,however,those in research group,on the basis of control group,were treated by mifepristone.The clinical efficacy,serum levels ofβ-HCG and the incidence of adverse reactions were observed and compared between the two groups.Results The total effective rate in research group was 95.56%,which was significantly higher than that(77.78%)in control group(P<0.05).After treatment,the serum levels ofβ-HCG in both groups were decreased,moreover,which in research group were significantly lower than those in control group(P<0.05).After treatment,the levels of FSH,E2,LH and T in both groups were significantly improved(P<0.05),moreover,which in research group were superior to those in control group(P<0.05).In addition the incidence rate of adverse reactions in research group was 20.00%,which in control group was 11.11%,there was no statistical significance between the two groups(P>0.05).Conclusion Methotrexate combined with mifepristone has obvious curative effects on ectopic pregnancy,which can reduce the serum levels ofβ-HCG and promote the absorption of ectopic pregnancy mass without increasing the incidence of adverse reactions,it is safe and reliable.