不同剂量米非司酮治疗子宫肌瘤106例临床观察

目的:比较12.5 mg/d和25 mg/d两组剂量的米非司酮治疗子宫肌瘤的疗效及其副作用,以及评估停药后肌瘤反跳生长的情况。方法:选取106例确诊为子宫肌瘤的患者,分别予米非司酮12.5 mg/d和25 mg/d,连续服用3个月。用药前后用B超测量子宫肌瘤的三维径线,同时评估患者血清中血红蛋白浓度、临床症状改善情况及子宫内膜情况,并对患者进行1年随访,观察子宫肌瘤反跳生长情况。结果:两组剂量米非司酮均明显改善子宫肌瘤患者相关的临床症状,提升血红蛋白及缩小子宫肌瘤体积,两组间差异无统计学意义(P>0.05)。停药后分别比较两组3个月、6个月和9个月的反跳率,差异均无统计学意义(P>0.05)。米非司酮12.5 mg/d组发生子宫内膜不规则增生率显著低于25 mg/d组(P<0.05)。结论:米非司酮治疗子宫肌瘤25 mg/d和12.5 mg/d两个剂量均能缩小肌瘤体积、改善临床症状,但以12.5 mg/d剂量更为安全。米非司酮治疗子宫肌瘤后反跳率高,建议最好作为术前用药。

Clinical observation on 106 cases with hysteromyoma treated with mifepristone of different doses

Objective:To compare the curative effects and adverse reactions of mifepristone of different doses(12.5 mg/d and 25 mg/d) in treatment of hysteromyoma,evaluate the re-growth of hysteromyoma after drug withdrawal.Methods:106 cases diagnosed as hysteromyoma were selected and treated with mifepristone of different doses(12.5 mg/d and 25 mg/d) for three months,the three-dimensional diameters of hysteromyoma were measured by ultrasound before and after treatment;the serum hemoglobin concentration,improvement of clinical symptoms and endometrial conditions were evaluated;all the cases were followed up for one year,re-growth of hysteromyoma was observed.Results:Mifepristone of different doses(12.5 mg/d and 25 mg/d) significantly improved the related clinical symptoms,increased the concentration of serum hemoglobin and reduced the volume of hysteromyoma,but there was no significant difference between the two groups(P>0.05);there was no significant difference in rebound rate of hysteromyoma among 3,6 and 9 months after drug withdrawal(P>0.05);the incidence of irregular hyperplasia of endometrium in 12.5 mg group was significantly lower than that in 25 mg group(P<0.05).Conclusion:Mifepristone of different doses(12.5 mg/d and 25 mg/d) can reduce the volume of hysteromyoma and improve clinical symptoms,but mifepristone of 12.5 mg is more safe;the rebound rate of hysteromyoma treated with mifepristone is high,the use of mifepristone before operation is suggested.