米非司酮对子宫内膜异位症患者的疗效观察及卵巢储备功能的影响

目的观察米非司酮(mifepristone,RU-486)治疗子宫内膜异位症(endometriosis,EMS)的疗效、副作用及不良反应和卵巢储备功能的影响。方法30例确诊为EMS的患者,以RU-486,10 mg/d,口服,3个月后,比较试验前后临床疗效(疼痛评分、子宫活动度评分、后陷凹结节大小、附件包块大小);于服药前月经第3天、停药时、停药后第1次月经恢复第3天,采用化学发光法测定雌二醇(E2)、孕激素(P)、睾酮(T)、卵泡刺激素(LH)、黄体生成激素(FSH)变化;观察用药期间的副作用及不良反应。结果试验组在治疗后月经期与非月经期疼痛评分、子宫活动度评分、后陷凹结节大小、附件包块大小均较治疗前明显改善,差异有统计学意义(P<0.05);停药时E2明显高于治疗前、停药后第1次月经恢复第3天及正常对照组,差异有统计学意义(P<0.05);P、T、LH、FSH与治疗前、停药时、停药后第1次月经恢复第3天及正常对照组比较无明显变化(P>0.05)。治疗后第1次月经恢复第3天E2、P、LH、FSH,与治疗前、停药后、正常对照组比较,无明显差异(P>0.05)。副作用及不良反应包括:胃部不适2例,便秘3例,乳痛1例,头痛2例,潮热2例,轻度肝脏转氨酶(ALT、AST)异常2例。结论连续3个月每天口服米非司酮10 mg治疗EMS有效,短期服用对EMS患者的卵巢储备功能无影响。

The efficacy and side effects and the influence to ovarian reserve function of mifepristone(RU 486)used in treatment of patients suffered endomertiosis

Objective To investigate the efficacy and side effects and the influence to ovarian reserve function of mifepristone （RU-486） used in treatment of patients suffered endometriosis （EMS）. Methods 30 patients who suffered EMS were treated with RU-486（ 10mg, po, Qd）for 90 days. And dysmenorhhea score, index of uterine mobile and size of vaginal fornix nodus and ovary endometriosis cyst were examined before treatment and at the end of treatment. E2 ,P,T,LH and FSH were examined before treatment and on the day of stopping the drug and on the 3rd day of menstruation restarted after finished study. Similarly, the same markers were measured in the controlled group on the 3rd day of menstrual cycle. And the side effects during treatment were recorded. Results Dysmenorhhea score,index of uterine mobile and size of vaginal fornix nodus and ovary endometriosis cyst were improved significantly （ P 〈 0. 05 ）. The level of E2 of stopping drug were higher than those of before treatment and on the 3rd day of menstruation restarted after finished study and control group（ P 〈 0.05 ）. There were no difference of the level of P, T, LH and FSH between before and after treatment and control group （ P 〉0. 05 ）. Side effects include ： Stomach discomfort （2 cases）, constipation （3 cases）, mastalgia （ 1 case）, headace（ 2 cases）, morderate liver transaminase abnormality （ 2 cases）. Conclusions Taking miefpristone 10 mg every day of for 3 month was effective and didn＇t influence the ovarian reserve function in patients with endometriosis.