米非司酮对子宫肌瘤患者血清脂联素的影响

目的观察米非司酮对子宫肌瘤患者血清脂联素的影响,探讨其缩小肌瘤的机制。方法60例子宫肌瘤患者随机分为两组。米非司酮组40例,每日服用米非司酮10mg,共3个月;Enantone组20例,每月皮下注射Enantone3.75mg,共3个月。分别于治疗前后采静脉血化验Hb、血脂、血糖;用免疫化学发光法测定血清皮质醇(C)、雌二醇(E2)、孕酮(P)、促黄体生成素(LH)、促卵泡素(FSH),用酶联免疫分析法测定血清脂联素水平;测量子宫及肌瘤三维径线。凡肌瘤体积缩小20%以上者,为有效组;肌瘤体积缩小不足20%者,为无效组。结果平均子宫肌瘤体积米非司酮治疗有效组比用药前缩小了45.5%(P<0.05),Enantone组缩小了47.5%(P<0.05),两组缩小程度无差异。无效组体积增大18.74%(P<0.05)。血清脂联素水平治疗后有效组明显上升(P<0.05),无效组明显下降(P<0.05),Enantone组用药前后无明显变化(P>0.05)。3组用药前脂联素水平相比较无显著性差异(P>0.05),用药后脂联素水平相比较差异有显著性(P<0.05)。结论脂联素在子宫肌瘤的增殖中起一定的直接或间接的促进作用。米非司酮可能通过调节脂联素水平抑制子宫肌瘤细胞的生长。

Effect of mifepristone on adiponectin in uterine leiomyoma

Objective:To study the effect of mifepristone on adiponectin in uterine leiomyoma and its mechanism of shrinkage for leiomyoma.Methods:Sixty premenopausal women with leiomyomata were randomized to receive either 10 mg of mifepristone daily or enantone monthly for 3 months. Forty of 60 subjects were given 10 mg mifepristone and 20 subjects were injected with 3.75 mg enantone for 3 months. Before treatment (as baseline) and 12 weeks therapy,serum concentrations of adiponectin,hemoglobin levels,glucose,triglycerides and E2, P, FSH, LH and cortisol were obtained. Volume changes of leiomyoma and uterus were measured with ultrasonography. Volume decreased to 20% was effective.Results:Mean uterine volume decreased to 45.5% (P<0.05) in effective mifepristone group and 47.5% (P<0.05) in enantone group. Mean uterine volume increased to 18.74% in noneffective mifepristone group. Serum concentrations of adiponectin elevated significantly in effective mifepristone group and increased in noneffective mifepristone group and unchanged in enantone group. There was no significant difference among there groups before treatment but significant after treatment.Conclusion:Adiponectin could play a direct or indirect role in growth of uterine leiomyoma,mifepristone could inhibit the leiomyoma cells through regulating the serum concentrations of adiponectin.