米非司酮治疗子宫肌瘤并发贫血的效果观察  

Effect of Mifepristone on Uterine Leomyoma Complicated with Anemia

作　　者：陈昭日[1] 陈相英[1] 戴淼[1] 黄文波[1] 

机构地区：[1]潍坊医学院附属医院妇科,山东潍坊261031

出　　处：《潍坊医学院学报》2008年第2期97-100,共4页Acta Academiae Medicinae Weifang

摘　　要：目的观察米非司酮治疗子宫肌瘤并发贫血的临床效果以及组织中雌激素受体（ER）、孕激素受体（PR）和微血管密度（MVD）的变化。方法米非司酮组为20例临床诊断为子宫肌瘤合并不同程度贫血，有手术指征的患者，从月经第1天起给予米非司酮12．5mg／d口服，连续30d，第31～91天8mg／d口服。停药后立即手术；对照组为同期手术的36例未服用米非司酮的子宫肌瘤患者。米非司酮组患者于用药前后分别行盆腔妇科检查和B超测定子宫和最大肌瘤体积；两组手术后子宫标本均采用ER，PR单克隆抗体免疫组织化学法检测子宫肌层、肌瘤组织的ER，PR表达，同时采用Ⅷ因子标记法观察两组子宫肌瘤组织中微血管密度（MVD）。结果①米非司酮组治疗后子宫体积和最大肌瘤体积均较治疗前明显减小（P〈0．01），血红蛋白明显上升（P〈0．01）。②米非司酮组子宫肌瘤组织中ER，PR表达仍高于肌层组织（P〈0．05）；米非司酮组子宫肌瘤组织中ER，PR表达低于对照组（P〈0．01）；两组肌层组织中ER，PR表达无明显差异（P〉0．05）。③米非司酮组子宫肌瘤组织微血管密度（MVD）低于对照组（P〈0．05）。结论小剂量米非司酮治疗是安全有效的，降调肌瘤的ER和PR，缩小子宫和肌瘤的体积，通过引起闭经缓解贫血。Objective Observing the clinical effectiveness of mifepristone on uterine leomyoma complicated with anemia and the change of the positive rates of estrogen receptors（ER） ,progesten receptors（PR） and microvessel density（MVD） in human uterine leiomvoma,myometrium,after mifepristone treatment,to discuss the effects of low-dose of mifepristone on uterine leiomyoma. Methods Twenty patients with uterine myoma complicated with anemia received 12.5mg of mifepristone daily for 30 days beginning on the first day of menstrual cycle,8 mg daily for another 60 days. Hysterectomy was performed just when the treatment finished. Control group included 36 patients sufferes from leomyomas with no mifepristone treatmen. At the beginning and the end of treatment,we monitored the changes of the uterus and the lagest myoma with B-us and gynecological examinations. Myometrial and leiomyomata tissue were obtained for immunohistochemical ER,PR an- alyses using monoclonal antibody. Leiomyomata microvessel density was counted in two groups. Results （1）The volume of uterine and the lagest mvoma were significantly reduced after the treatment （ P 〈 0.01 ）, blood serium Hb is elevated obviously （ P 〈 0.01 ） （2）After 90 days of mifepristone treatment,in the mifepristone group, ER and PR positive rate in leiomyoma were still higer than those of myometrium（P 〈 0. 01 ）. ER and PR positive rate in leiomyoma in study group were significantly less than those of control group（ P 〈0.01 ）. （3）ER and PR positive rate in myometrium of study group was similar to that of control group （ P 〉 0.05 ）. （4）The exppressin of MVD in the leiomyoma of the study group was less than that in the control group（ P 〈 0.05 ）. Conclusion Mifepristone has significant effect in the treatment of uterine leiomvoma. The perhaps mechanism of its treatment was that it can significantly decrease ER and PR in leiomyoma but not in myometrial tissue.

关 键 词：米非司酮 子宫肌瘤 治疗 

分 类 号：R737.33[医药卫生—肿瘤]