孕激素水平对药物流产结局的影响  

The effect of the serum progesterone level before medical abortion on the sequel

作　　者：朱海斌[1] 孙莉颖[1] 宋文耀[1] 

机构地区：[1]浙江大学医学院附属第一医院妇科,杭州310003

出　　处：《浙江医学》2005年第3期176-177,226,共3页Zhejiang Medical Journal

摘　　要：目的探讨孕激素水平在米非司酮与米索前列醇联合药物流产(简称药流)中的变化及其对药流结局的影响。方法测定早孕者服用米非司酮前后血清孕激素水平(P1、P2)及孕囊排出后宫腔内膜的孕激素受体(PR)水平,P1、P2采用化学发光法测定,PR采用右旋糖苷标记二步法测定,比较药流成功组(193例)与失败组(22例)各项指标的差异。结果药流成功组P1(21.33±4.42)ng?ml低于失败组(24.83±4.98)ng?ml(t=4.382,P<0.05);药流成功但出血时间≤10d者与>10d者比较,前者P1(20.15±3.66)ng?ml,明显低于后者(25.34±2.44)ng?ml(t=5.623,P<0.05);而两组间PR表达差别无显著性意义(t=1.541,P>0.05)。结论用药前血孕激素高于25ng?ml可能影响米非司酮拮抗P的作用,导致药流的失败。药流前高P值是影响药流后出血时间的一个重要因素。Objective Mensurate the progesterone level (P) and progesterone receptor (PR) during the process of Mifepristone adoption to determine the effect of the serum progesterone level on the sequel of medical abortion. Methods 215 cases take mifepristone and misoprostol were selected during may, 2001 and may ,2003. The progesterone level before and after the using of mifepristone were determined(P1?P2)with chemic luminosity method.We also determined the PR in deciduas after embryo discharging through labelled dextran polymer method. The purpose is to find the relationship of these index with the sequel of medical abortion. Results The P1 level of the successful group (n=193) is (21.33±4.42 )ngml. The failure group's (n=22)P1 level is(24.83±4.98)ngml .The former is lower than the latter significantly(t=4.382,P<0.05).In successful group.Cases whose bleeding time less than 10 days have the P1 level of (20.15±3.66) ngml, while the P1 level is (25.34±2.44)ngml in cases bleeding longer than 10 days(t=5.623,P<0.05).There are no differents between the groups in expression of PR. Conclusion The level of progesterone before Mifepristone adoption have the influence on the sequel of medical abortion.If the level is above 25ngml, the treatment maybe fail. The level also have the contribution to the bleeding time of the medical abortion.

关 键 词：药流 孕激素 对药 药物流产 米非司酮 PR 结局 标的 显著性 水平 

分 类 号：R169.4[医药卫生—公共卫生与预防医学]