米非司酮对早孕妇女血浆生殖激素及蜕膜和绒毛组织中前列腺素水平的影响

本文用放免法测定了妊娠35～67d妇女口服米非司酮100mg前和48h后血浆中E2、P、PRL、βhCG水平和妊娠40～56d口服米非司酮48h后蜕膜和绒毛组织中的PG（2α）、PGE2、TXB2和6－keto－PGF（1α）水平的变化。结果显示米非司酮使血浆P水平降低（P＜0．01）；PRL水平增加（P＜0．01）；E。在用药后48h继续呈上升趋势，但与用药前无显著统计学差异；E2／P和PRL／P比值增力。（P＜0．05，P＜0．01）。6－keto－PGF（1α）在用药后有腹痛和／或子宫出血受试者蜕膜组织中的水平明显高于无症状受试者和对照组；绒毛组织中PGF（2α）、TXB2和6－keto－PGF（1α）水平在用药后有腹痛和／或子宫出血者和无症状受试者都明显高于对照组（P＜0．05，P＜0．005），PGF（2α）／PGE2比值也明显增加（P＜0．05）。结果显示了来非司酮对早孕妇女的综合影响，包括改变内分泌激素之间和PGS之间比率的平衡，改变内分泌激素和PGs的浓度，促使子宫收缩及宫颈软化等。

The Effects of Mifepristone on Plasma Reproductive Hormones and Decidual and Placental Villi Prostaglandin Concentrations in Early Pregnant Women

This study determined by RIA the plasma concentrations of E2,P,PRL and β-hCG in early pregnancy from 35 to 67 days 48 h before and after orally administrating 100 mg of mifepristone,and decidual and placental villi PGF(2α),PGE(2α),TXB2 and 6-keto-PGF(1α) levels in early pregnancy from 40 to 56 days 48 h after orally administrating 100 mg of mifeprisone. Mifepristone decreased plasma P concentrations,but moresed plasma PRL levels (P<0. 01). E, was continualy raised after treatment with mifepristone,showing no significant difference as compared with pre-treatment. The ratios of E2 to P and of PRL to P were significantly increased (P<0. 05,P<0. 01).β-hCG levels in plasma had no difference as compared with pre-treatment.Decidual 6-keto-PGF(1α) level was remarkably increased in the group of abdominalgia and /or uterine bleeding after treatment than in the groups of no symptom after treatment and in the control. The PGF(2α),TXB2 and 6-keto-PGF(1α) levels in placental villi were significantly increased inthe groups both of abdominalgia and/or uterine bleeding and of no symptom after treatment with mifepristone than in the control groups. The ratio of PGF(2α) to PGE2 in placental villi was also markedly raised.The results suggested that the mechanism of mifepristone terminating early pregnancy was of multiple factors,including imbalance in the ratio between reprodutive hormones and PGs,change of the levels of P,PRL and PGs,stimulation of uterine contraction,dilatation of cervix and so on.