dl—15-甲基前列腺素F_(2α)合并丙酸睾丸酮抗早孕的临床研究新进展(Ⅱ)

本研究在前一阶段工作的基础上,进一步缩短了15-甲PGF_(2α)疗程和减少用药量,并以β-hCG放射免疫测定为主要指标,观察抗早孕效应。停经49天以内的60例早孕妇女随机分为两组,每组30例。组Ⅰ的15-甲PGF_(2α)最高用量为10毫克,组Ⅱ为8毫克;两组用药疗程均为8小时(比以前缩短4小时)。丙酸睾丸酮用法同前。结果两组抗早孕有效率分别为96.67%和100%(p>0.05);15-甲PGF_(2α)平均用量分别为9.67±0.21和7.70±0.19毫克(p<0.05)。组Ⅱ用药比组Ⅰ少2毫克,更适于门诊推广应用。本文并对β-hCG放射免疫测定在药物抗早孕研究中的应用及丙酸睾丸酮的抗早孕机理进行了讨论。

A FURTHER CLINICAL STUDY OF TERMINATION OF EARLY PREGNANCY BY ADMINISTRATION OF LONG-ACTING DL-15-METHYL-PROSTAGLANDIN F_(2α) IN COMBINATION WITH TESTOSTERONE PROPIONATE(Ⅱ)

Sixty cases of early pregnancy with periods of amenorrhea 49 days or less countedfrom the last menses were terminated by using long acting dl-methyl-PGF_(2α) (15-me-PGF_(2α))in combination with testosterone propionate (TP) and divided into two study groups atrandom. The procedure was to use two 15-me-PGF_(2α) sponges (4mg each) in the vaginalvault at an interval of 4 hours, then followed by an intramuscular injection of 2mg15-me-PGF_(2α) 4 hours later in group Ⅰ. The only difference in the treatment of group Ⅱwas to reduce the dosage of the 15-me-PGF_(2α) sponge to 3mg each. The maximum dosageof 15-me-PGF_(2α) was limited to 10mg in group Ⅰ and 8mg in group Ⅱ. The complete courseof 15-me-PGF_(2α) in both groups was not more than 8 hours, a period which was shorter by 4hours than with the previous study. Besides this, before the administration of 15-me-PGF_(2α),a dose of 100mg TP was injected each day intramuscularly for 3 days in all cases. The suc-cess rates for the two groups were 96.67% and 100% respectively (P>0.05). The meandosage of 15-me-PGF_(2α) in group Ⅱ was reduced from 9.62 mg (as used in group Ⅰ) to 7.70mg (P<0.05) without any apparent reduction in the success rate. Gastrointestinal side effects appeared to be less frequent and less severe in group Ⅱ,although significant difference could not be demonstrated due to the limited size of the studygroup. In general, side effects were tolerated by the patients, because the course of treat-ment was short and the symptoms usually subsided rapidly after completion of the treatment.According to the present study we think that the method for the termination of early preg-nancy experimented in group Ⅱ could be applied in the out-patient department. In addit-ion, we also have used radioimmunoassay of β-hCG to diagnose early pregnancy and eval-uate the effects of the above-given medication in this study. We found that the hCGdoubling time was delayed greatly in early pregnant women after TP administration, themean time being 11.67±1.7 days (Mean±SE). This suggests that the secretion of hCGin early pregnancy could be inhibited by TP. Thus TP seems to enhance the effect of 15-me-PGF_(2α) in the termination of early pregnancy.