子宫内膜异位症非根治性手术后应用米非司酮的远期疗效及其对性激素的影响(1)
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【摘要】 目的 探索对非根治性子宫内膜异位症术后患者,长期服用小剂量米非司酮对临床症状改善及性激素水平的影响。 方法 选择200例非根治性腹腔镜手术后确诊为子宫内膜异位症的患者,术后口服米非司酮治疗6个月(25 mg/d×3个月;之后12.5 mg/d×3个月)。分别于服药前,服药后3个月及6个月,停药后3、6及12个月进行B超及妇科检查了解盆腔情况,同时采集外周血测定性激素水平。 结果 服药6个月后临床总有效率为95.5%(191/200),停药后1个月左右月经恢复正常。治疗有效者中有6例在停药后的6个月内复发(6/191,3.1%),27例在停药后1 年内症状再次加重或复发(27/191,14.1%)。口服米非司酮后,血清E2水平降至卵泡中期水平,FSH和PRL水平在治疗前、后均无明显变化(P>0.05)。血 P水平比用药前显著降低(P<0.05),LH稍升高(P>0.05)。结论 非根治性子宫内膜异位症术后长期服用小剂量米非司酮,可有效提高其远期疗效,对月经及性激素的影响是可逆的。其不良反应少,安全性较高。
【关键词】
子宫内膜异位症;米非司酮;性激素
Longterm Effects of Mifepristone in the Treatment of Nonradical Postoperative Endometriosis and its Impact on Sex hormones
CHEN Yanhui.Guangzhou Red Cross Hospital.Guangzhou 510220,China
【Abstract】 Objective To explore longterm effects of lowdose mifepristone in nonradical postoperative
DOI:10.3760/cma.j.issn 16738799.2010.01.15
作者单位:510220广州市红十字会医院
endometriosis patients and its impact on sex hormones.Methods 200 cases of endometriosis who underwent nonradical laparoscopic surgery were included in the study.Continuous treatment of oral mifepristone was given to those patients for 6 months(25 mg/d for 3 months and then 12.5 mg/d for another 3 months).Bultrasound and pelvic examination were conducted before treatment,3 months and 6 months after medication,3 months,6 months and 12 months after discontinuation of treatment respectively.Peripheral blood was collected to evaluate the changes of sex hormones.Results The overall effectiveness after 6 months treatment was 95.5%(191/200).Normal menstruation was resumed 1 month after the discontinuation of treatment.6 cases relapsed within 6 months,and 27 cases relapsed within 1 year after the discontinuation of treatment respectively(6/191,3.1%;27/191,14.1%).After oral administration of mifepristone,serum E2 decreased to the midfollicular levels.Serum FSH and PRL levels remained unchanged(P>0.05).Serum progesterone levels decreased significantly after treatment(P<0.05).LH increased insignificantly(P>0.05).Conclusion Continuous use of lowdose mifepristone can improve longterm effects of nonradical postoperative endometriosis ......
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