米非司酮治疗子宫内膜异位症及其不孕的临床观察

The clinic research of mifepristome on the endomtriosis and infertility

为了探讨米非司酮 (Mife)治疗子宫内膜异位症 (内异症 )及其不孕的疗效及安全性 ,对 49例内异症不孕患者采用Mife低剂量长期服药 ,对其临床症状、体征、超声声像图变化、内分泌变化及结合促排卵、助孕技术的妊娠结局进行了观察。结果显示 ,Mife治疗内异症的总有效率为 90 82 % ;所有患者在治疗结束后 1～ 2个月均恢复月经来潮 ;14例Mife用药满 6个月者行生殖内分泌激素检查 ,血清促黄体生成素 (LH)、促卵泡激素 (FSH)水平与治疗前比较 ,无显著性差异 (P >0 0 5 ) ,雌二醇 (E2 )均维持在卵泡中期水平 ,经治疗内异症明显改善者的妊娠率为 5 9 2 6%。 2例在治疗期间阴道淋漓流血 ,病理检查证实为子宫内膜腺囊样增生。认为Mife可有效地缓解内异症症状 ,抑制内异症发展 ,副作用少 ,使用方便 ,价格低廉 ,尤其对于内异症所致不孕者 ,不影响其卵巢储备 。

To explore the effectiveness and safety of mifepristone(Mife) on the patients with endometriosis and infertility,49 patients were treated with Mife in low daily doses(10mg per day) for 90 to 180 days.The total effectiveness rate is 90.82%.Menstruation recovered in all patients in 1 to 2 months after treatment.14 patients, who were treated with Mife for 180 days,were given serum hormone(LH,FSH,E 2)assessment in the middle follicular phase.Median FSH and LH concentrations have no significant changes compared with that before treatment,E 2 maintains at the middle follicular phase level. The pregnancy rate were 59.26% among the effectiveness-improved cases.This suggests that Mife plays an important role in the treatment for endometriosis, especially for the infertility related to endometriosis.