不同低剂量米非司酮治疗子宫腺肌病伴痛经患者的疗效研究

目的:通过比较不同低剂量米非司酮(RU486)治疗子宫腺肌病伴有痛经的疗效,以筛选合适低剂量RU486治疗子宫腺肌病伴痛经的方案。方法:选择子宫腺肌病伴痛经的68例患者,分别给予RU486每周25mg(Ⅰ组,n=33)、每天5mg(Ⅱ组,n=24)和每天2.5mg(Ⅲ组,n=11)治疗,比较观察治疗前后子宫大小、血清CA125水平、VAS评分、月经量、子宫内膜厚度以及血红蛋白含量的变化。结果:服药后3个月和6个月,3组患者的VAS评分与月经量均显著低于服药前(P0.05),血红蛋白含量显著高于服药前(P0.05)。Ⅰ组患者服药后3个月与6个月的血清CA125水平均低于服药前(P0.05),但服药后3个月和6个月的子宫体积与内膜厚度与服药前比较,差异均无显著性(P0.05)。Ⅱ组患者服药后3个月的血清CA125水平与子宫体积均显著低于服药前(P0.05),服药后6个月的血清CA125水平与子宫体积与服药前比较,差异均无显著性(P0.05),但子宫内膜厚度显著高于服药前(P0.05)。Ⅲ组患者服药后6个月的血清CA125水平与内膜厚度均显著高于服药前(P0.05),但服药后3个月和6个月的子宫体积与服药前比较,差异均无显著性(P0.05)。结论:小剂量RU486均可有效治疗子宫腺肌病患者的痛经症状,但由于RU486(25mg/周)方案服用间隔时间长且方便同时又不增加子宫内膜厚度可作为短期治疗子宫腺肌病伴痛经患者的首选。

Comparative analysis of the therapeutic effects of mifepristone with different low doses for the treatment of adenomyosis women with dysmenorrhea

Objective:To investigate the therapeutic effects of different low doses of mifepristone ( RU486 ) on adenomyosis women with dysmenorrhea so as to obtain an appropriate dose of RU486 for the treatment of adenomyosis. Methods:A total of 68 adenomyosis patients with dysmenorrhea were treated with 25mg RU486 weekly (group I:25mg/w,n=33),5mg RU486 daily (group II:5mg/d,n=24) and 2. 5mg RU486 daily (group III:2. 5mg/d,n=11) ,respectively. Before and after treatment,the uterine size,serum CA125 levels,VAS score, menstrual amounts,endometrial thickness and hemoglobin levels were analyzed comparatively. Results:Three and six months after treatment,the VAS scores and menstrual amounts in group I,II and III were all significantly lower than those before treatment (P<0. 05),while the hemo-globin levels were all significantly higher than those before treatment (P<0. 05). In group I,se-rum CA125 levels after treatment for 3 and 6 months were all lower than those before treatment ( P<0 . 05 ) , but no significant differences of uterine volume and endometrial thickness were found between 3 and 6 months after treatment (P>0. 05). In group II,serum CA125 levels and uterine volume after treatment for 3 months were both significantly lower than those before treat-ment(P<0. 05),and endometrial thickness after treatment for 6 months were significantly high-er than those before treatment (P<0. 05). However,serum CA125 levels or uterine volume after treatment for 6 months did not reach significant difference when compared with those before treatment(P>0. 05). In group III,serum CA125 levels and endometrial thickness after treat-ment for 6 months were both significantly higher than those before treatment (P<0. 05),but no significant difference of uterine volume between before and after treatment was found ( P>0 . 05 ) . Conclusions:These results suggest that different low doses of RU486 can be used to treat adenomyosis patients with dysmenorrhea effectively,but 25mg RU486 weekly might be the priority choice for the short-term treatment of adenomyosis with dysmenorrhea because it is con-venience,has long time interval and does not increase endometrial thickness.