小剂量米非司酮对生殖内分泌的影响

目的探讨小剂量米非司酮对生殖内分泌的影响。方法随机抽取门诊就诊的子宫肌瘤或子宫腺肌病患者40例。均于月经的第5天开始服用米非司酮6.25mg/d,连续服用4个月,于用药前及停药1周内测量卵巢的面积以估计卵巢的大小,空腹测量血清雌二醇、FSH(卵泡刺激素)的水平,应用SPSS11.5统计软件进行数据处理。结果米非司酮治疗后,右卵巢面积小于治疗前,两者比较,差异有显著性(P<0.01)。米非司酮治疗前血雌二醇为卵泡期水平,治疗后为绝经期水平,两者比较,差异有显著性(P<0.01)。米非司酮治疗前后FSH差异无显著性(P>0.05)。结论小剂量米非司酮对垂体没有明显抑制作用,但具有雌激素样的负反馈作用;小剂量米非司酮通过抗雌激素样作用直接作用于卵巢,导致卵泡发育停止,从而使卵巢激素缺乏周期性变化而出现闭经,并伴随出现卵巢缩小及更年期症状。

Study on the influence of low-dose mifepristone in reproductive endocrine system

Objective To study on the influence of low-dose mifepristone in reproductive endocrinology endorine system.Methods Forty women with uterine leiomyomata or adenomyosis were chosen randomly as the control group in this study.All took mifepristone 6.25 mg daily for four months from the fifth day of menstruation cycle.Ovarian area,the serum E2 levels and FSH levels were measured before treating and after ending treatment.SPSS11.5 statistics software was carried on datas.Results E2 level before treating was placed in the follicular phase of the cycle.However,E2 level treated with mifepristone descended obviously（P0.01）,being placed in the postmenopausal phase.FSH level had no obvious difference（P0.05） between treated with mifepristone and untreated with it.Right ovarian area was significantly smaller than that before treating（P0.01）.Conclusion Low-dose mifepristone can not inhibit the secretory function of adenohypophysis obviously,but affect it by negative feedback because of mifepristone＇s estrogen effection.Low-dose mifepristone can influence directly the ovary by its anti-estrogen effection,as a result ovarian follicle stop growth,sex hormone lose periodic variety.So the women treated with mifepristone occur amenorrhea and accompany with Uterine regression,ovarian regression and menopause symptom.