米非司酮在异位妊娠药物治疗中的作用及孕酮在其监测中的意义探讨

目的:探讨不同剂量米非司酮和甲氨喋呤(MTX)联用治疗异位妊娠的效果以及血清孕酮(P)检测在其治疗过程中的价值。方法:选择适合药物治疗的异位妊娠患者79例随机分为3组,A组25例:MTX40mg/m2单次肌肉注射;B组34例:MTX用法同A组加米非司酮150mg口服;C组20例:MTX用法同A组加米非司酮300mg口服。治疗过程中监测B超、血清β-HCG和孕酮(P)。结果:3组治疗成功率、平均住院日等方面均无显著性差异(P>0.05),检测血清β-HCG和孕酮发现孕酮(P)<5ng/ml所需时间明显短于平均住院日(P<0.05),血清β-HCG下降正常所需时间与孕酮(P)<1.5ng/ml所需时间相比明显延长,差异有显著性意义(P<0.05)。结论:米非司酮治疗异位妊娠作用不肯定,一定范围内剂量大小无明显意义,而孕酮在其安全性监测方面有临床价值,值得推广应用。

Observation on the effect of Mifepristone and the significance of serial progesterone titers in the treatment of ectopic pregnancy

Objective:To compare the clinical outcome of the different chooses of Mifepristone in treatment of ectopic pregnancy. To observe the significance of serial progesterone titers in using medical therapy.Methods:Total of 79 cases of ectopic pregnancy were diagnosed as unrupture tubal pregnancy that be divided into three groups: Group A was treated with MTX single-dose(40mg/m2) intramuscular injection. Group B was treated with MTX single-dose(40 mg/m2) intramuscular injection combined with oral Mifepristone(150mg). Group C was treated with MTX as same as group A combined with oral Mifepristone(300mg).Serial βHCG and progesterone titers were obtained when treatment.Results:There was no difference in curative rates and time of hospitalization among three groups.The shorten time that progesterone down to 5ng/ml level differed from the time of hospitalization,and there was significant difference in time of retiring to normal level between the βHCG titers and progesterone titers.Conclusion:The choose of Mifepristone dosage is no as to the outcome in treating ectopic pregnancy. The serial progesterone titers in using medical therapy is worth to popularizing in clinical practice.