米非司酮配伍米索前列醇终止早期妊娠的效果观察

米非司酮配伍前列腺素能有效终止早孕,使药物终止早期妊娠替代手术治疗。抗孕激素制剂米非司酮主要作用于子宫内膜（蜕膜）的孕酮受体,具有明显的催经止孕作用;米索前列醇使宫颈组织胶原纤维分解,具有促宫颈成熟的效果,在妇产科领域中的大量研究和实践证明,米索前列醇配伍米非司酮是     

消炎痛对兔子宫内孕酮和雌二醇受体含量及其转移的影响

前列腺素对孕卵植入和蜕膜形成起重要作用。前列腺素合成抑制剂——消炎痛对大鼠和小鼠可阻断孕卵植入,而对仓鼠、兔可部分抑制植入,消炎痛的抗植入效应不能因同时给孕酮(P)和17β-雌二醇(E_2)而抵消。消炎痛也能抑制蜕膜形成。体内和体外研究中用消炎痛后可阻止假孕大鼠子宫内孕酮受体复合物从胞浆向胞核转移,如在培养基     

米非司酮配伍米索前列醇终止早期妊娠（综述）

1985年首次证明米非司酮配伍前列腺素能有效终止早孕,使药物终止早期妊娠替代手术治疗成为现实。抗孕激素制剂米非司酮主要作用于子宫内膜（蜕膜）的孕酮受体,具有明显的催经止孕作用;米索前列醇使宫颈组织胶原纤维分解,具有促宫颈成熟的效果,在妇产科领域中的大量研究和实践证明,米索前列醇配伍米非司酮是药物流产的有效方法。米非司酮配伍米索前列醇抗早孕的流产成功率可达95％,且其作用专一,使用方便,副作用小。现将米非司酮、米索前列醇的抗早孕作用机制及其在妇产科临床应用综述如下：     

口服药物流产的应用

药物流产是一种非手术流产,使用方便、安全无痛、可接受性强.近20年来,国内外在探索有效地终止早孕药物方面已有显著进展,口服药物流产仍是终止早孕的更为先进的新方法.目前主要采用口服米非司酮配伍米索前列醇终止早孕.现简述如下:1 药理作用及临床特点1.1 米非司酮(Mifepristone简称Ru486)Ru486是法国Roussel-Uclaf公司80年代初首先合成并成功地用于临床.是作用于受体的新型抗孕酮的甾体药物,用于终止早孕已在20多个国家应用.Ru486无孕激素、雌激素、雄激素和抗雄激素活性,含有抗孕酮和抗肾上腺激素的成份,对孕酮受体的亲和力比黄体酮强5倍.它主要作用于下丘脑和(或)垂体,抑制卵泡刺激素、黄体生成素及卵巢激素的分泌.在靶细胞上竞争性地抑制可取代体内孕酮,与孕酮受体结合,抑制孕酮活性,导致体内绒毛膜促性腺激素水平急剧下降,继之黄体溶解,从而引起子宫蜕膜和绒毛变性,内源性前列腺素(PG)释放,进一步促进宫缩和软化,扩张宫颈,最终引起孕产物的排出.所以Ru486具有诱发月经,抑制排卵,抗着床,终止妊娠、死胎引产和避孕作用.     

米非司酮对人早孕绒毛和蜕膜组织结构的影响

<正> 米非司酮为孕酮受体拮抗剂,通过与孕酮竞争受体,阻断其生物效应而终止妊娠,大量临床试验证实,米非司酮配伍前列腺素是安全、高效的终止早孕方法。本文通过观察米非司酮对绒毛和蜕膜组织结构的影响,进一步探讨米非司酮的抗早孕机理。 材料和方法 一、研究对象 1999年1月～5月在河北省人民医院计划生育科门诊就诊孕妇。符合下列条件:身体健康,年龄18     

终止妊娠新药抗孕唑啉的一般药理作用研究

目的:研究抗孕唑啉(L14105)对呼吸、心血管、中枢神经系统及子宫肌的作用。方法:用麻醉猫观察该药对血压、呼吸、心电图的影响;描记家兔大脑皮层电图的变化;L14105与戊巴比妥钠合用对小鼠睡眠时间的影响;观察对子宫肌收缩的影响。结果:静脉注入60mg/kg体重使猫心率减慢,120mg/kg体重对血压和呼吸均无影响;50mg/kg体重对家兔皮层电图无明显影响;肌肉注射50mg/kg体重与戊巴比妥钠合用使小鼠睡眠时间延长;对离体或在位子宫肌均可增强收缩力。结论:L14105可增强子宫肌节律性收缩;与戊巴比妥钠合用具中枢抑制协同作用;大剂量可减慢心率。     

LIF在米非司酮药物流产蜕膜组织中的表达及意义

目的:通过对比观察米非司酮对早孕蜕膜组织中白血病抑制因子(LIF)表达的影响,探讨米非司酮终止早孕的分子免疫机制。方法:采用免疫组化染色测定蜕膜组织中LIF的表达,其中正常早孕人工流产组20例,米非司酮药物流产组22例。同时采用放射免疫法测定两组孕妇血清孕酮及人绒毛膜促性腺激素(HCG)水平。结果:LIF在正常早孕蜕膜组织中均呈阳性表达,主要在蜕膜组织腺体和内膜细胞染色较明显。LIF在米非司酮药物流产组表达强度较人工流产组明显降低(P<0.01);药物流产组血清孕酮及HCG水平显著低于人工流产组(P<0.01)。结论:米非司酮明显降低LIF在蜕膜组织中的表达,引起HCG及孕酮分泌下降,从而影响胚胎发育引起流产,达到终止早孕的目的。     

小说药流

随着医学科学的发展，近年来一种新型的方法——“药物流产”正式被推广使用。８０年代抗早孕药米非司酮问世，对于药物流产具有划时代的意义。到了９０年代人们再一次发现用治疗胃溃疡的药物——米索前列醇，同前者合用，应用于终止早期妊娠效果更佳。 米非司酮具有抗受精卵着床、诱导月经及促进宫颈成熟的作用，其催经止孕的机理主要是通过竞争内膜（蜕膜）的孕酮受体，阻断孕酮的作用，使好娠蜕膜变性、出血、坏死，直至流产。米索前列醇作用于子宫收缩，使已剥离的胚囊自宫内排出。 该药只需连服３天，前２天在家或工作岗位上服用，每次…     

米非司酮终止早孕成功88例临床分析

米非司酮是作用于受体水平的甾体类抗孕酮药物，它能阻断孕酮受体，使蜕膜变性、坏死、出血，加用前列腺素后加强宫缩排出绒毛。现已成为非手术终止早孕的一种安全、可靠、高效、简便易行的好方法。我院自2004年5月至12月对88例早孕妇女应用米非司酮配伍米索前列醇进行药物流产，现将结果报告如下。     

抗孕激素RU486研究现状和展望

抗孕激素RU486的研制成功是抗生育药物研究领域的显著进展之一。它主要作用于子宫内膜(蜕膜)的孕酮受体,具有明显的催经止孕作用。许多临床试验表明RU486与前列腺素类似物序贯用药可使早孕妇女的流产成功率达90%以上,且作用专一、使用方便、副作用小;本品尚有可能用作排卵后抗生育药物。本品及其同系物在妇产科等领域的临床应用亦有广阔的前景。     

On the mode of action of a new contragestational agent (DL 111-IT)

Non-hormonal compounds belonging to 3,5-diphenyl-1H,1,2,4 triazoles and chemically related classes (triazoles in short) are known to be endowed with high contragestational activity in rodents, dogs and primates. The data herein reported for one of the leaders of this family of compounds (DL 111-IT) along with those previously reported for some analogues, demonstrate that triazoles cause pregnancy arrest by a direct action on conception product. This action is expressed through a progressive slowing down of the conceptus development with a consequent onset of a state of anoxia, pregnancy arrest, degeneration of placentae and adnexae and their absorption or expulsion. The selective time of gestation during which they elicit the antifertility effect (early post-implantation period) and the histological examinations revealed that the target of their action are the ectoplacental and decidual cells. Biochemical studies on conceptus product demonstrate that, although they do not bind to progesterone receptors or inhibit ornithine decarboxylase activity, triazoles induce an early and marked increase in the number of cytosol progesterone receptors accompanied by a steep decrease in the ornithine decarboxylase activity in the product of conception. These findings are discussed in relation to the possibility that triazoles may trigger pregnancy arrest by interfering with the chain of events by which progesterone regulates the mitotic activity of decidual and trophoblastic cells.     

三苯氧胺对人早孕蜕膜和绒毛超微结构的影响

目的:从超微结构水平,观察三苯氧胺对蜕膜和绒毛超微结构的影响。方法:将停经40～45天的早孕妇女 9例,随机分 3组,正常对照组 3例,三苯氧胺组 3例(三苯氧胺,20mg,2次/日,x4天),三苯氧胺并米索组2例,于第5天阴道内置米索800μg。结果:三苯氧胺主要使大蜕膜细胞皱缩,粗面内质网肿胀,线粒体体积变小。蜕膜颗粒细胞中高电子密度颗粒减少,而绒毛合体滋养细胞则表现不同程度的退行性改变。并用米索后其对蜕膜及绒毛滋养细胞的损伤进一步加重。结论:三苯氧胺主要使大蜕膜细胞和合体滋养细胞发生退行性改变而起到抗早孕作用。     

人绒毛膜促性腺激素注射前血清孕激素升高的持续时间对体外受精-胚胎移植的影响

目的:探讨在控制性促排卵(COS)过程中人绒毛膜促性腺激素(h CG)注射前孕激素水平升高的持续时间对体外受精-胚胎移植(IVF-ET)妊娠结局的影响。方法:选取2012年1月—2014年12月在安徽医科大学附属省立医院生殖医学中心行IVF-ET或胞浆内单精子注射(ICSI)-ET助孕的1 132例不孕症患者的临床资料。根据h CG注射日血清孕激素水平分4组:A1组h CG注射日孕激素水平3.18 nmol/L,共521例;A2组h CG注射日孕激素水平3.18~6.36 nmol/L,共338例;A3组h CG注射日孕激素水平6.36~7.95 nmol/L,共197例;A4组h CG注射日孕激素水平7.95 nmol/L,共76例。根据h CG注射前(包括h CG注射日及前一日)血清孕激素水平持续2天在同一范围的患者分为3组:B1组孕激素水平3.18 nmol/L,共220例;B2组孕激素水平3.18~6.36 nmol/L,共116例;B3组孕激素水平6.36 nmol/L,共62例。对上述各组的临床资料进行回顾性分析,比较各组患者的促排卵效果及周期妊娠结局。结果:h CG注射日不同孕激素水平的4组患者年龄、不孕年限、促性腺激素(Gn)天数、Gn用量、获卵数、正常受精率、可移植胚胎率和优质胚胎率的比较差异均无统计学意义(均P0.05)。A4组与A1组比较,胚胎种植率、生化妊娠率、临床妊娠率和活产率差异均具统计学意义(均P0.008)。与B1组相比,B2组和B3组的胚胎种植率、临床妊娠率及活产率下降,差异有统计学意义(均P0.017),B3组的生化妊娠率也比B1组低,差异有统计学意义(P0.017)。结论:COS过程中,h CG注射日孕激素水平7.95 nmol/L及h CG注射前连续2天孕激素水平≥3.18 nmol/L对IVF-ET的妊娠结局具有负面影响。     

Anordiol is more potent than anordrin for terminating pregnancy when administered with RU 486

In view of the unexpected ability of anordrin to synergize with RU 486 in terminating pregnancy, it was pertinent to examine the actions of the dihydroxylated metabolite of anordrin, anordiol, alone and in combination with RU 486. Doses of RU 486 (1 mg/kg/day) and anordiol (0.6 mg/kg/day) that were ineffective when given alone terminated pregnancy with complete resorption of embryos when administered together. A smaller dose of anordiol than anordrin is required to achieve this synergistic effect with RU 486. This anordrin metabolite increased uterine weight in the ovariectomized rat similar to estradiol. The estrogenicity of anordiol in the uterine weight assay was about 1/120 of that of estradiol. Anordiol does not exert antiestrogenic activity in the uterine weight assay when administered at doses that terminate pregnancy. Administration of anordiol at doses that do not terminate pregnancy resulted in a significant suppression of serum progesterone concentrations during the period of medication; these observations suggest that anordiol has an inhibitory effect on progesterone biosynthesis. When the same dose of anordiol was given concomitantly with sufficient RU 486 (e.g., 1 mg/kg/day) to terminate pregnancy, the progesterone levels were reduced to low levels throughout the experiment. These observations support the postulate that the actions of anordrin are mediated by its metabolite, anordiol. The administration of anordiol plus RU 486 results in a more dramatic change in the functional progesterone:estradiol ratio than when either agent is administered alone.     

Antireproductive effect of a potent LHRH antagonist (Nal-Lys antagonist:antide) during early pregnancy in the rat

Effects of a potent third generation LHRH antagonist [Nal-Lys antagonist:antide] have been observed during the first half of pregnancy in rats. A daily dose of 40 micrograms or above, when administered from day 8 of pregnancy, suppressed serum progesterone levels within 48 h and by day 12 there was complete absence of live fetuses. Lower doses of antide (10-20 micrograms) reduced progesterone levels in circulation but were unable to induce abortion consistently in all treated rats. Administration of 150 or 300 micrograms of antide once on day 8 suppressed the progesterone levels within 24 h. Only a dose of 300 micrograms was effective in completely interfering with gestation by day 12 with no observable live fetuses.     

不同剂量米非司酮胶囊终止10～14周瘢痕子宫妊娠的疗效观察

目的:探讨不同剂量米非司酮胶囊配伍卡前列甲酯终止瘢痕子宫10～14周妊娠的效果。方法:选择2009年5月～2011年9月收治的剖宫产手术1年内妊娠10～14周的非意愿孕妇113例随机分为两组,对照组50例口服米非司酮胶囊50 mg,观察组63例口服米非司酮胶囊100 mg,48 h分4次服完,12 h后给予卡前列甲酯栓1 mg阴道后穹窿或肛门用药,如6 h未见妊娠物排出,可再次给予卡前列甲酯栓1 mg,24 h内不超过3 mg。结果:观察组在有效率、上栓后妊娠物排出时间、阴道出血量等情况均明显优于对照组,但阴道出血时间无明显差异。结论:应用100 mg米非司酮胶囊终止10～14周瘢痕子宫妊娠较50 mg效果明显。     

妊娠期急性脂肪肝不同终止妊娠时机对妊娠结局的影响

目的:探讨改善妊娠期急性脂肪肝预后的有效方法。方法:选取本科室2004年1月-2011年6月住院治疗的30例妊娠期急性脂肪肝患者为延迟组,入院后保肝治疗,尽量延长孕周,若肝肾功减退则终止妊娠。选取2011年7月-2015年10月住院治疗的30例确诊后立即终止妊娠的妊娠期急性脂肪肝患者作为立即组。对两组临床资料进行回顾性对比研究,包括临床表现、实验室检查、诊断治疗、预后转归等。同时以发病至终止妊娠时限分组,发病至终止妊娠间隔3d的为早期干预组,发病至终止妊娠3~7d的为中期干预组,发病至终止妊娠7d的为晚期干预组,比较不同时段对该病的诊断时间及术前处理对妊娠结局的影响。结果:终止妊娠后48h,立即组丙氨酸氨基转移酶(ALT)(127±11.3)U/L,天冬按酸氨基转移酶(AST)(201±11.7)U/L,总胆红素(TBIL)(218±12.5)μmol/L,直接胆红素(DBIL)(87.8±9.56)μmol/L,总蛋白(TP)(30.4±3.67)g/L,凝血酶原时间(PT)(17.5±1.57)s,活化部分凝血活酶时间(APTT)(37.8±6.11)s,延迟组ALT(218±12.5)U/L,AST(286±14.2)U/L,TBIL(183±13.2)μmol/L,DBIL(141±10.9)μmol/L,TP(23.9±3.01)g/L,PT(23.3±2.13)s,APTT(49.0±9.01)s,P值分别为0.012,0.035,0.022,0.040,0.039,0.049,0.045,差异均有统计学意义;立即组术中出血量(325±147.8)ml,术后24h出血量(405±161.2)ml,延迟组术中出血量(557±182.2)ml,术后24小时出血量(613±197.9)ml,P值分别为0.006,0.008,差异均有统计学意义;早期诊治的妊娠期急性脂肪肝患者肝功能、凝血功能均得到更好的改善,产后出血量明显减少,减少了孕产妇病死率的发生,但孕产妇严重并发症、新生儿窒息率及围生儿病死率差异无统计学意义(P0.05)。结论:早期诊断、确诊AFLP后48h之内及时终止妊娠、终止妊娠前后输注血浆或冷沉淀补充凝血因子、多学科综合治疗是改善妊娠期急性脂肪肝预后的有效方法。     

米非司酮终止妊娠与Th1/Th2调节的相关性研究

目的：探讨米非司酮终止妊娠者血清及蜕膜组织液中Th1/Th2型细胞因子的水平及临床意义。方法：采用酶联免疫吸附法检测50例口服米非司酮终止妊娠妇女（药流组）血清及蜕膜组织液中Th1（IL-2、IFN-γ）/Th2（IL-4、IL-10）型细胞因子水平,同时以50例正常健康早孕妇女,要求行人工流产终止妊娠者作为人流组。结果：药流组血清及蜕膜组织中IL-2、IFN-γ的水平明显高于人流组,而IL-4、IL-10含量明显低于人流组,这种变化与药物流产次数无关。结论：米非司酮可以改变流产妇女血清及蜕膜组织液中Th1/Th2平衡,从而终止妊娠。     

Diallyl trisulfide modulates cell viability and the antioxidation and detoxification systems of rat primary hepatocytes

This study investigated the effects of various concentrations of diallyl trisulfide (DATS) and incubation times on cell viability, glutathione (GSH) content, and GSH-related enzyme activity in rat primary hepatocytes. Isolated and cultured primary rat hepatocytes were used as an experimental model. Cells were treated with 0 (control), 0.025, 0.05, or 0.25 mmol/L DATS for 0, 4, 8, or 24 h. After 24 h of treatment, some cells were incubated in fresh medium without DATS for an additional 24 h (48-h incubations). Based on lactate dehydrogenase (LDH) leakage and morphological examination, hepatocytes treated with 0.025 mmol/L DATS did not differ from the control cells at 4, 8, 24, and 48 h of incubation. However, LDH leakage was higher than in the control cells (P < 0.05) when the hepatocytes were treated with 0.05 or 0.25 mmol/L DATS for 4 h or more. The intracellular GSH levels of hepatocytes treated with 0.025 or 0.05 mmol/L DATS were higher than those of the control cells (P < 0.05), whereas those treated with 0.25 mmol/L DATS did not differ. The activity of glutathione reductase (GRd) was higher than in the control cells at 24 h (P < 0.05) when the hepatocytes were treated with 0.025 mmol/L DATS. When the hepatocytes were treated with 0.025 mmol/L DATS, the activity of glutathione S-transferase (GST) was higher than in the control cells at 48 h (P < 0.05). In hepatocytes treated with 0.05 mmol/L DATS, the activity of GST and glutathione peroxidase (GPx) was higher than in the control cells (P < 0.05) at 24 and 48 h of incubation. The results indicate that 0.025 or 0.05 mmol/L DATS could enhance antioxidation and detoxification capabilities by increasing the intracellular GSH level and the activity of GPx, GRd, or GST in rat primary hepatocytes. However, 0.05 or 0.25 mmol/L DATS might adversely affect the viability of hepatocytes.