米非司酮治疗子宫肌瘤后患者血清VEGF及VEGFR2水平的变化

目的探讨米非司酮对子宫肌瘤患者血清血管内皮生长因子(VEGF)及血管内皮生长因子受体2(VEGFR2)的影响。方法选择71例至少有1个瘤体≥3 cm的子宫肌瘤患者,自月经来潮第5天开始,口服米非司酮25 mg,每日2次,连续服用3个月。分别在服药前后测定血清VEGF、VEGFR2、促卵泡生成素、促黄体生成素、雌激素、孕激素的浓度,同时用B超检测服药前后子宫和最大肌瘤体积、肌瘤数量及子宫动脉搏动指数和阻抗指数。结果服药后患者血清VEGF及VEGFR2水平较服药前显著减低,子宫动脉搏动指数明显下降,而阻抗指数明显升高。结论米非司酮可通过抑制血清VEGF和VEGFR2水平及有效减少子宫动脉血流来缩减肌瘤体积。

The Change of serum vascular endothelial growth factor and its receptor 2 after treatment by mifepristone in patients with uterine leiomyoma

Objective It is to approach the influence of mifepristone on serum vascular endothelial growth factor and its receptor 2 in patients with uterine leiomyoma,and further investigate the mechanism of mifepristone on the treatment of uterine leiomyoma.Methods 71 patients were selected which each with at least one tumor diameter ≥ 3cm.From the fifth day after menstruation,patients received 25 mg,twice per day,totaling 3 months.The levels of serum vascular endothelial growth factor(VEGF),vascular endothelial growth factor receptor 2(VEGFR2),follicle stimulating hormone,luteotrophic hormone,estradiol and progestogen were detected before and after therapy.Likewise,the maximum tumor size,tumor number,the uterus artery pulse index and the resistive index were detected by B-mode ultrasonography.Results The levels of VEGF and VEGFR2 after therapy were significantly lower than before therapy.The level of VEGFR2 was correlated with the number of tumor.Moreover,the uterine artery pulse index was significantly lower than before therapy,and resistive index was significantly higher than before therapy.Conclusion Mifepristone could diminish the size of uterine leiomyoma by inhibit the levels of VEGF and VEGFR2,and decrease the blood flow of uterus artery.