黄体期应用米非司酮对卵巢功能的影响

本研究旨在比较黄体期不同阶段应用米非司酮对黄体功能、卵泡发育、排卵和阴道出血类型的影响以探讨其生育调节的作用机理。１５名采取屏障避孕的健康育龄妇女，随机分成三组（组Ⅰ～Ⅲ），分别在黄体早、中、晚期给予米非司酮口服２５ｍｇｑ１２ｈ×６。每例对象在对照周期、服药周期和随访周期均接受采血，测定其血清ＦＳＨ、ＬＨ、ＰＲＬ、Ｅ２和Ｐ的水平，记录其阴道出血量及时间。结果显示服药后阴道出血类型和激素水平的变化因服药时机而异。服药时间距ＬＨ峰愈近，则诱发阴道出血所需时间愈长，两者是显著负相关（ｒ＝－０．８７，Ｐ＜０．００１）。黄体早期用药（组Ⅰ）对黄体功能及出血类型无明显影响。黄体中期用药（组Ⅱ）者中，３例孕酮水平提前下降，服药周期缩短，提示黄体过早溶解；另２例在月经预期来潮之前亦有一次阴道出血，但其孕酮水平并未随之下降，提示黄体未提前萎缩。黄体晚期用药（组Ⅲ）对服药周期无明显影响；但是在随访周期，２例对象卵泡发育缓慢，排卵明显延迟，并且其黄体期也缩短。

Changes in Ovarian Activity Inducedby Mifepristone Administered in Luteal Phase

The purpose of this study was to compare the changes in luteal function,follicular development,ovulation and menstrual cycle as well as pituitary gonadotropic secretion in Chinese womenadministered with mifepristone during early,mid-and late luteal phase to elucidate endocrinologically the action mode of mifepristone for post ovulatory fertility regulation. Fifteen healthy,fertile woman volunteers taking barrier contraception were divided into three groups (GroupⅠtoⅢ)at random and orally administered with mifepristone 25mg q12h×6 in early,mid-and lateluteal phase respectively.Each Subject received blood sampling for measurement of serum FSH,LH,PRL,E2 and progesterone(P)levels by RIA,and were required to record date and amount ofvaginal bleeding in pre-and post-treatment cycles as well as the treatment cycle.The resultsshowed that the changes in mestrual cycle and hormone profiles varied with the time of drug administration related to serum LH peak.The shorter the duration from the first dose to LH peak,the longer the period between the first dose and vaginal bleeding. There was a very significantnegative correlation (r= -0.87,P<0. 001 ).The effects of mifepristone was not significant as administered in early luteal phase (GroupⅠ).While P levels decreased prematurely and the treatedluteal phase was shortened in 3 cases,which indicated premature lutealysis;in contrast,p levelsdid not reduced prematurely in other two cases having two episodes of mestrual cycle when treatment was in mid -lutdal phase (GroupⅡ).However,treatment cycle was not affected remarkablyby medication in late luteal phase (Group Ⅲ ). While in two patients follictuar development andovulation delayed obviously,and luteal phase was shortened during post-treatment cycle.