来曲唑与克罗米芬治疗多囊卵巢综合征不孕症临床疗效比较

目的比较来曲唑与克罗米芬治疗多囊卵巢综合征不孕症的疗效。方法选取120例不孕症患者并随机分为来曲唑组(LE组)和克罗米芬组(CC组),每组各60例患者。两组患者均服用炔雌醇环丙孕酮片1次/d、1片/次,盐酸二甲双胍片2次/d、1片/次,治疗3~6周调整患者的内分泌相关指标至正常后停药。LE组从月经或黄体酮撤退性出血的第5天开始,口服来曲唑片1片/d、5 d,CC组服用克罗米芬1次/d、1粒/次。B超监测子宫内膜和卵泡发育情况,肌肉注射人绒毛膜促性腺激素(HCG)5 000~10 000 U诱发排卵。比较两组患者HCG注射日卵泡发育、子宫内膜等相关指标及性激素水平、排卵效果、妊娠结局。结果 LE组成熟卵泡个数及平均直径、螺旋动脉血流阻力指数低于CC组,而子宫内膜厚度、宫颈黏液Insler评分和宫腔容积均高于CC组,两组间比较,差异均有统计学意义(P<0.05)。LE组的雌二醇水平低于CC组,而黄体生成素峰时间大于CC组,两组间比较,差异均有统计学意义(P<0.05)。LE组患者排卵率、多胎妊娠率、未破裂卵泡黄素化综合征发生率及卵巢过度刺激综合征发生率均明显低于CC组,而生化妊娠率及临床妊娠率均明显高于CC组,两组间比较,差异均有统计学意义(P<0.05)。结论对于多囊卵巢综合征不孕症患者,应用LE妊娠率较高,且未破裂卵泡黄素化综合征及卵巢过度刺激综合征发生率均明显低于应用CC者。     

两种不同促排卵方案对宫腔内人工授精妊娠结局的影响研究

目的 分析两种不同促排卵方案(克罗米芬、来曲唑+人绝经期促性腺激素)对宫腔内人工授精妊娠结局的影响.方法 抽取生殖中心治疗的236例行宫腔内人工授精(1698周期)患者(2010年11月～2014年10月)作为实验的目标对象,对236例行宫腔内人工授精患者的临床资料进行分析,分析比较自然周期(NC)人工授精及克罗米芬(CC)、来曲唑+人绝经期促性腺激素(LE+ HMG)不同促排卵方案行宫腔内人工授精的妊娠结局.结果 CC组HCG日子宫内膜厚度显著低于NC组及LE+ HMG组,P＜0.05;CC组、LE+ HMG组的＞16 mm优势卵泡数、排卵数以及优势卵泡直径均高于NC组,P＜0.05;促排卵周期组的临床妊娠率显著高于NC组,P＜0.05;促排卵周期组与NC组的自然流产率和异位妊娠率无显著区别,P＞0.05;LE+HMG组的临床妊娠率显著高于CC组和NC组,P＜0.05;NC组及CC组、LE+HMG组之间的自然流产率和异位妊娠率均无明显差别,P ＞0.05.结论 促排卵治疗可有效提高IUI的临床妊娠率,且不会影响患者的自然流产率和异位妊娠率,相比于CC方案,LE+HMG方案可有效提高患者的临床妊娠率,且自然流产率和异位妊娠率较低,安全性更高.     

氯米芬与来曲唑在多囊卵巢综合征不孕患者中促排卵作用比较

目的探讨枸橼酸氯米芬(CC)和来曲唑(LE)在多囊卵巢综合征(PCOS)不孕患者中促排卵的作用。方法选择2014年1月至2015年12月在上海市沃德医疗中心就诊的PCOS不孕患者,随机分为研究组(n=120)和对照组(n=115)。研究组和对照组分别在月经第3天开始应用LE 5 mg和CC 100 mg促排卵,应用5 d后停药,并在至少一个卵泡直径达20 mm时注射10 000 IU的h CG。比较两组患者直径≥14 mm卵泡(优势卵泡)数、直径≥18 mm卵泡数及注射h CG时子宫内膜厚度、促排卵后内分泌指标、周期妊娠率等。结果研究共纳入235例PCOS患者,给予LE促排卵(研究组)的120例中,39例妊娠,周期妊娠率为32.5%,给予CC促排卵(对照组)的115例中,15例妊娠,周期妊娠率为13.0%,两组间比较差异有统计学意义(P<0.01)。注射h CG时,对照组子宫内膜厚度(9.4±0.2)mm,高于观察组的(8.0±0.3)mm,差异有统计学意义(P<0.05)。促排卵后,对照组组患者的血清雌激素、孕激素和黄体生成素水平均高于观察组,而FSH水平和AMH水平低于观察组,差异均有统计学意义(P<0.05)。结论与对照组比较,应用LE对PCOS不孕患者进行促排卵治疗,对子宫内膜影响小,周期妊娠率高。     

来曲唑和克罗米芬对多囊卵巢综合征患者的促排卵效果比较

目的探讨来曲唑和克罗米芬对多囊卵巢综合征(PCOS)患者的促排卵效果比较。方法将2016年1月-2018年1月治疗的120例PCOS患者随机分为两组,对照组采用克罗米芬,观察组采用来曲唑,比较两组患者的卵泡大小及个数、内膜厚度、排卵率、妊娠率、多胎率、流产率、宫外孕率。结果观察组成熟卵泡数明显少于对照组、子宫内膜厚度明显厚于对照组(P<0.05),成熟卵泡大小与对照组无明显差异(P>0.05),而两组在卵泡成熟所需天数上无明显差异(P>0.05);观察组妊娠率明显高于对照组(P<0.05),两组在排卵率、多胎率、流产率、宫外孕率上无明显差异(P>0.05)。结论来曲唑对PCOS患者的促排卵效果更佳,能有效促进卵泡成熟和排出,提高妊娠率。     

达因35联合小剂量地塞米松治疗多囊卵巢综合征的效果分析

目的：通过观察达因35联合小剂量地塞米松治疗多囊卵巢综合征（ PCOS）的临床效果,探讨PCOS高雄激素血症的有效治疗途径。方法将68名高雄激素血症性PCOS患者随机分为两组,分别给予口服达因35（达因组）和达因35联合小剂量地塞米松（地塞米松组）治疗3～6个周期,比较治疗前后PCOS患者多毛痤疮、肥胖指数、卵泡发育和排卵率以及血清激素的变化,并进行统计学分析。结果达因35和达因35联合小剂量地塞米松能够明显降低PCOS患者体内促黄体生成素（ LH）、游离睾酮（ FT）、雄烯二酮（ A）、硫酸脱氢表雄酮（DHEA－S）、17－羟孕酮（17－OHP）的水平,治疗3个周期地塞米松组显著低于达因组（P＜0.01）,治疗6个周期两组比较差异无显著性（ P＞0.05）;治疗3个周期达因35联合小剂量地塞米松可明显改善PCOS患者多毛、痤疮、卵泡发育和排卵率,与达因组比较差异有显著性（ P＜0.05）。结论小剂量地塞米松可协同达因35治疗PCOS高雄激素血症并明显缩短达因35的治疗周期,同时显著改善高雄激素血症引起的慢性无排卵、多毛痤疮等临床症状。     

阴道B超监测卵泡评分预防卵巢过度刺激综合征的研究

目的：探讨对PCOS患者进行促排卵过程中阴道B超监测卵泡评分预防OHSS发生的作用。方法：将128例行促排卵后IUI的PCOS患者分为评分组（58例）与普通组（70例），对照促排卵效果、妊娠结果与OHSS发生情况。结果：两组患者排卵率、妊娠率与轻、中度OHSS发生率无显著性差异（P＞0．05），评分组注射HCG日14mm以上卵泡个数显著低于普通组（P＜0．05），无1例重度OHSS发生，普通组3例（P＜0．05）。结论：根据卵泡评分对PCOS患者的促排卵用药进行指导，可以有效地减少重度OHSS发生率。     

阴道超声卵泡评分在补肾中药联合尿促性素诱导排卵中的应用

目的：观察阴道超声卵泡评分在补肾中药联合HMG诱导排卵中的应用价值。方法：53例排卵障碍性不孕患者随机分为中药＋HMG组（28例,67个周期）和HMG组（25例,66个周期）,测定HMG周期用药量、优势卵泡个数及卵泡评分,对比两组周期妊娠率及OHSS率。结果：中药＋HMG组周期用药量较HMG组明显减少,HCG注射日优势卵泡个数、卵泡评分及周期妊娠率显著高于HMG组（P〈0.05）,两组OHSS率未见差异。结论：阴道超声卵泡评分可用于中西医结合诱导排卵周期,提高周期妊娠率,且有助于降低OHSS发生率。     

排卵障碍患者用来曲唑与尿促性腺激素方案促排卵对子宫内膜形态的影响的比较

目的:探讨排卵障碍患者用来曲唑方案与尿促性腺激素方案对子宫内膜形态的影响。方法:回顾性分析2009年1月-2011年4月我院门诊就诊的排卵障碍患者60例,共计80个促排卵周期,其中,来曲唑组34个周期,尿促性激素组46个促排卵周期。比较hCG日两组间子宫内膜厚度,形态,优势卵泡数目、排卵数及妊娠结局。结果hCG日来曲唑组子宫内膜厚度为8.700±2.6952mm,尿促性腺素组子宫内膜厚度为9.463±1.9537mm,P>0.05,差异无统计学意义,但在形态上,来曲唑组子宫内膜A、A-B型为52.9%,而尿促性腺激素组为16.5%两组间差异有统计学意义。来曲唑组平均优势卵泡个数为1.4706±1.3311,尿促性激素组为3.5217±4.0756个,两者比较,P<0.05,差异有统计学意义。结论:排卵障碍患者用来曲唑方案与尿促性腺激素方案相比并不降低周期妊娠率,且来曲唑方案有更明显的单卵泡发生率,可获得更好的子宫内膜形态。     

超声引导下小卵泡穿刺术配合启宫丸治疗多囊卵巢综合征不孕症的临床观察

目的:研究启宫丸配合小卵泡穿刺术治疗多囊卵巢综合征(PCOS)不孕症患者的临床疗效,探讨其对患者内分泌及胰岛素抵抗指标、基础窦卵泡计数的影响。方法:将70例PCOS患者随机分为2组:中药组及对照组,2组都用人绝经期促性腺激素(hMG)促排卵后,在超声引导下经阴道小卵泡穿刺治疗,中药组同时口服启宫丸,连用2个周期,比较治疗前后早卵泡期患者的基础性激素卵泡刺激素(FSH)、促黄体素(LH)、睾酮(T)、胰岛素(FINS)及性激素结合球蛋白(SHBG)等指标及卵巢基础窦卵泡计数的变化。结果:共进行了140个周期的穿刺治疗,治疗后2组患者T、LH、FINS水平及LH/FSH比值均明显降低,SHBG水平明显升高(P<0.05),基础窦卵泡计数有显著性减少(P<0.05),治疗后中药组血FINS、SHBG水平较对照组差异有统计学意义(P<0.05)。结论:对PCOS患者应用启宫丸配合超声引导下小卵泡穿刺技术可改善其内分泌异常及胰岛素抵抗状态,减少基础窦卵泡计数,恢复排卵功能而妊娠。     

小剂量阿司匹林辅助治疗对多囊卵巢综合征不孕患者疗效、激素及胰岛素抵抗的影响

目的 研究小剂量阿司匹林辅助治疗多囊卵巢综合征(Polycysticovary syndrome, PCOS)不孕症对患者治疗效果、激素以及胰岛素抵抗(IR)的影响。方法 选取2020年3月-2022年3月收治的90例多PCOS不孕患者作为研究对象,随机分为对照组和研究组,分组方法为随机数表法。对照组患者采用来曲唑诱导排卵,研究组患者在对照组基础上加用小剂量的阿司匹林治疗,对比两组患者治疗前后子宫内膜的厚度、优势卵泡数、妊娠率、治疗前后激素水平的变化以及IR情况。结果 研究组患者在优势卵泡分别发育至10-12 mm、14-16 mm以及18-20 mm时,子宫内膜厚度均明显厚于对照组(P<0.05);治疗后研究组的排卵率以及妊娠率均要高于对照组(P<0.05),IR指数低于对照组(P<0.05)。研究组治疗后孕酮(P)、雌二醇(E₂)的水平均高于对照组;促黄体生成素(LH)、卵泡刺激素(FSH)水平均低于对照组(P<0.05)。研究组治疗后凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)高于对照组,D-二聚体(D-D)和纤维蛋白原(F...     

短期重复使用几种精神药物对小鼠自主活动和脑单胺递质的影响

目的 观察短期重复使用几种精神药物对小鼠自主活动和脑单胺递质的影响,以评价药物作用的耐受性和副作用。方法 雄性小鼠作为实验对象。中枢兴奋药实验分3组（每组n＝6）：①对照组;②咖啡因（Caf）组30mg/kg;③右旋苯丙胺（Dex）组10mg/kg。催眠药实验分4组（每组n＝6）：①对照组;②三只仑（TZ）组0．04mg/kg;③速可眠（Sec）组60mg/kg;④裉黑素（Mel）组120mg/kg。小鼠灌胃给药,1次／d。于第1天和第7天称重和测定自主活动。Dex和TZ连续用药7d后,用高效液相色谱法测定小鼠大脑皮层单胺递质及其代谢产物的变化。结果 ①对照组和用药组的体重差异无显著性意义;②连续用药7d,Caf和Dex对自主活动的兴奋作用较第1天明显增强（P＜0．05）;③连续用药7d,虽然催眠药对小鼠自主活动仍有显著的抑制作用,但作用强度较之第1天明显降低（P＜0．05）;④Dex和TZ连续用药7d,小鼠在脑皮层单胺递质水平明显改变,但Dex组的双羟基苯乙酸（DOPAC）和5－羟基吲哚乙酸（5－HIAA）及TZ组的5－HIAA明显降低（P＜0．05）。结论 ①连续应用催眠药1周,其作用有一定的耐受性;②重复使用Dex和TZ1周对鼠脑单胺递质的代谢可能产生不良影响。     

低剂量托伐普坦在2型心肾综合征合并低钠血症超高龄老年患者中应用近期临床评价

目的观察托伐普坦治疗2型心肾综合征合并低钠血症超高龄老年患者的近期疗效及安全性。方法回顾性分析沈阳军区总医院干诊科自2013年1月至2015年12月住院的26例超高龄慢性心肾综合征合并低钠血症老年患者的临床资料,平均年龄(95.2±7.5)岁。所有患者在维持长期治疗方案基础上,予托伐普坦7.5 mg/d口服3 d后,改为(3.75~7.50)mg,qod治疗7 d后停用。随访20 d。主要评估服药第3天、第10天及随访结束时的日均血钠值的变化。同时,观察患者尿量、心衰体征、血压、心率及不良事件,定期检查肝、肾功能,N末端B型脑钠肽前体(N-pro-BNP)及电解质,进行疗效及安全性评估。结果在原治疗基础上,联合托伐普坦治疗后第3天和第10天,日均血钠分别为(134.6±1.5)mmol/L和(141.9±3.5)mmol/L,显著高于治疗前的(130.2±2.4)mmol/L,差异有统计学意义(P<0.05)。所有患者尿量显著增加,治疗第3天尿量(1615.8±643.7)ml较治疗前(678.8±215.9)ml显著增加(P<0.01)。治疗3 d后浮肿缓解明显。治疗结束时N-proBNP为(2 520.3±1421.6)pg/ml,较治疗前(5 865.3±2 031.8)的pg/ml明显下降(P<0.01)。eGFR较前无进一步下降,而第10天eGFR为(41.5±6.7),较治疗前的(38.8±6.2)略有升高(P<0.05)。治疗结束后随访,第10天有1例患者出现高钠血症(156.2 mmol/L),经对症后纠治。有1例出现肝损害。结论低剂量托伐普坦能够有效纠治2型心肾综合征超高龄老年患者的低钠血症,减轻心衰症状,不加重肾脏损害,改善其近期预后,可安全用于超高龄患者,但仍需严密监测不良事件发生。     

Assessment of 99mTc-DMSA renography and uptake compared with creatinine clearance in rats with drug-induced nephrotoxicity--II. Cisplatin-induced nephrotoxicity]

For evaluation of technetium-99m dimercaptosuccinic acid (99mTc-DMSA) renal uptake as an absolute renal function, 99mTc-DMSA uptake was compared with endogenous creatinine clearance (Ccr) in cisplatin-induced nephrotoxicity. At first, Male Wistar rats were given intraperitoneally 1.8 mg/kg/day of cisplatin for periods of 3, 5, 7 and 9 days. On the next day, 99mTc-DMSA uptake and Ccr were measured. Ccr of 5-day treated group was significantly lower than that of control (0.13 +/- 0.10 vs 0.34 +/- 0.05 ml/min/100 g; p less than 0.01) but 99mTc-DMSA uptake did not change. 99mTc-DMSA uptake of 7-day treated group was significantly lower than that of control (28.57 +/- 7.23 vs 39.84 +/- 2.23%; p less than 0.01). As the second experiment, cisplatin (3.6 mg/kg/day) was given intraperitoneally on the 1st, 2nd, 15th and 16th day. On the 5th, 8th, 11th, 15th, 20th, 23rd, 26th and 30th day, the same measurements were done as the first one. Ccr was lower in cisplatin treated rats on the 5th day than that in control (0.10 +/- 0.03 vs 0.34 +/- 0.05 ml/min/100 g; p less than 0.01), thereafter tended to be recovered to the control level. On the other hand, 99mTc-DMSA uptake was lower than that of control on the 8th, 11th and 15th day (32.40 +/- 3.86, 32.56 +/- 1.19, 35.21 +/- 2.97 vs 39.84 +/- 2.23%, respectively; p less than 0.01). The discrepancy between 99mTc-DMSA uptake and Ccr was observed in the cisplatin-induced nephrotoxicity. 99mTc-DMSA uptake was suggested to be a reliable indicator of a renal function in a different way from Ccr.     

交替应用阿齐霉素与克林霉素治疗儿童支原体肺炎

目的：探讨阿齐霉素与克林霉素交替应用治疗儿童支原体肺炎的疗效及安全性。方法：回顾分析明确诊断为支原体肺炎患儿76例。阿齐霉素、克林霉素交替治疗组30例,第1-3天给予阿齐霉素针剂,1/d,10mg/（kg·d）,第4-7天给予盐酸克林霉素40mg/（kg·d）,分2次静脉滴注,第8-10天给予阿齐霉素针剂,1/d,10mg/（kg·d）。单用阿齐霉素组46例,分别在第1-3天和第8-10天静滴阿齐霉素针剂,1/d,10mg/（kg·d）。结果：阿齐霉素、克林霉素交替治疗儿童支原体肺炎疗效优于单用阿齐霉素组,副反应发生概率统计学差异无显著性。结论：阿齐霉素、克林霉素交替治疗支原体肺炎疗效好。     

Toxicity and Survival Results of a Phase II Study Investigating the Role of Postoperative Chemo-radioimmunotherapy for Gastric Adenocarcinoma

BACKGROUND AND PURPOSE: To investigate the role of postoperative concomitant chemo-radioimmunotherapy in gastric adenocarcinoma patients. PATIENTS AND METHODS: 59 patients, who underwent total or subtotal gastrectomy, with lymph node involvement, positive microscopic surgical margins or serosal involvement were included in the study. Radiotherapy started concomitantly with chemotherapy and levamisole. Extended-field radiotherapy was given to gastric bed and regional lymphatics via two anterior-posterior/posterior-anterior fields. A total dose of 45 Gy in 25 fractions with a fraction size of 1.8 Gy was planned. In 28 patients (48%) with positive surgical margins a 10-Gy boost dose was given to the anastomosis site. An adjuvant i.v. bolus of 450 mg/m(2)/day 5-fluorouracil (5-FU) was administered concomitantly during the first 3 days and at the 20th day of irradiation. After completion of radiotherapy, i.v. boluses of 450 mg/m(2)/day 5-FU and 25 mg/m(2)/day rescuvorin were continued for 6 months once a week. Levamisole 40 mg/day orally was started at the 1st day of radiotherapy and also continued for 6 months. Median follow-up was 37 months (7-112 months). RESULTS: Median survival was 23 months. Overall 3- and 5-year survival rates amounted to 35% and 14%, respectively. Median survival of the patients with positive surgical margins was 22 months. The 3- and 5-year locoregional control rates were 59% and 55%, respectively. The most common toxicity was upper gastrointestinal system toxicity, which was observed in 42 patients (71%). Four patients (7%) died on account of early toxic effects, and six (10%) could not complete treatment. CONCLUSION: Although 48% of the study population involved patients with microscopic residual disease, the survival results as a whole were satisfactory. However, due to high toxicity, radiotherapy must be delivered with the most proper techniques along with adequate nutrition and supportive care.     

The results of simultaneous radio-chemotherapy in advanced head and neck tumors

Patients suffering from locally advanced squamous cell carcinoma of the head and neck were treated with three courses of simultaneous radio-chemotherapy. Chemotherapy consisted of cis-platinum, 60 mg/m2 i.v. on day 2; 5-FU, 350 mg/m2 i.v. bolus on day 2; leucovorin calcium, 50 mg/m2 i.v. on day 2; 5-FU, 350 mg/m2/24 hrs continuously infused over 96 hrs from day 2 to day 5 and leucovorin calcium, 100 mg/m2/24 hrs continuously infused over 96 hours from day 2 to day 5 each course. Radiotherapy was administered from day 3 to day 11. 23.4 Gy were given in 13 fractions, twice a day with a minimum interval of four hours. This schedule was repeated on days 22 and 44. The total radiation dose amounted to 70.2 Gy/51 days. From 1984 to 1986, 62 patients were entered in this prospective trial. Three patients deceased due to massive hemorrhage during therapy, one patient was not eligible due to a second malignancy. 5/58 evaluable patients had a UICC-Stage III cancer, 53/58 had a UICC-Stage IV cancer. 48/58 (81%) showed a clinically complete response to therapy, 10/58 (17%) achieved partial response three months after the end of treatment. In 16/58 patients loco-regional cancer was not controlled (minimum follow-up 2 years), in 12/58 distant metastases occurred. Loco-regional control rate is estimated at 66% +/- 7% (Kaplan Maier).     

培美曲塞或多西他赛联合顺铂治疗晚期肺腺癌的疗效和不良反应

 目的 比较培美曲塞或多西他赛联合顺铂一线治疗突变状态未知的晚期肺腺癌的临床疗效、反应及生存期。方法 70例晚期肺腺癌患者,分别应用PP组(培美曲塞+顺铂)及DP组(多西他赛+顺铂)治疗。PP组35例,第1天静脉注射培美曲塞500 mg/m²;DP组35例,第1天静脉注射多西他赛75 mg/m²。第2~4天两组均联合顺铂25 mg/m²静脉滴注。21 d为1个周期,每例至少完成2周期后评价疗效及不良反应。结果 PP组中位无进展生存期8个月,中位生存时间14.3个月,1年生存率62.8%。DP组中位无进展生存期7个月,中位生存时间13.3个月,1年生存率65.7%。两组比较差异均无统计学意义。PP组血液学、消化道和肾功能毒性发生率明显低于DP组(P<0.05)。结论 PP或DP一线治疗晚期肺腺癌疗效相当,PP组不良反应较低,适合对于化疗耐受性不佳的患者。     

The role of humoral markers of inflammation activity in the evaluation of adequacy of antibacterial chemotherapy for community-acquired pneumonia

To determine the significance of results of dynamic study of C-reactive protein (C-RP) and ceruloplasmin (CP) concentrations in plasma for evaluation of adequacy of community-acquired pneumonia (CAP) launching antibacterial chemotherapy we investigated 97 patients (servicemen on draft). C-RP and CP were determined by immunoturbidimetric method. The blood samples were obtained on admission, on the 3rd-4th day of treatment and on the 7th-8th day of stay in the hospital. The transformations of pulmonary infiltrates were evaluated at the same periods with the use of digital chest fluorography. The strong correlation between transformations of pulmonary infiltrates for serum C-RP level (r=0.79) and CP level (r=0.71) was observed. The dynamic assessment of C-RP and CP levels is a simple and reliable test that permits to use it as an adjunctive procedure in C-RP diagnosis and evaluation of treatment effectiveness. The serum CRP level more than 110 mg/l and CP level higher than 6.3 mg/l should be considered as diagnostic and prognostic markers of severe CAP.     

硝酸异山梨酯在药物流产中的作用

目的探讨阴道内应用硝酸异山梨酯在药物流产中的作用。方法选择行药物流产的患者630名,孕期在35~49 d,因各种原因需人工终止妊娠。所有患者均口服米非司酮50 mg/d,连服3 d后,随机分为两组:一组(310例)米索前列醇600μg晨起空腹顿服(M组);另一组(320例)同样给予米索前列醇口服,之前1 h,阴道内置硝酸异山梨酯5mg(M I组);观察绒毛排出情况。结果M组绒毛排出平均所需时间(6.3±2.9)h,M I组所需时间(3.1±1.9)h,差别有统计学意义(P<0.05);3 h之内绒毛排出率M组及M I组分别为38.0%(119/310)和77.0%(247/320),差别有统计学意义(P<0.05);8 h内绒毛排出率没有区别;具有相同副反应。结论药物流产过程中,硝酸异山梨酯与米索前列醇有协同作用,且不增加其副作用。