小剂量米非司酮治疗子宫肌瘤作用机制探讨  

Effects of Low-dose Mifepristone on Uterine Leiomyoma

作　　者：张丽芹[1] 刘华[1] 陈相英[1] 邵明霞[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101-102,共2页Acta Academiae Medicinae Weifang

摘　　要：目的检测米非司酮治疗后子宫肌瘤患者的肌层、肌瘤组织中雌、孕激素受体(ER,PR)的表达的变化,探讨米非司酮治疗子宫肌瘤的作用机制。方法20例患者从月经第1天起给予米非司酮12.5mg/d,连续90d,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肌层、肌瘤组织的ER,PR表达。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)。②对照组子宫肌瘤组织中ER,PR表达均高于肌层组织(P<0.01)。③米非司酮组子宫肌瘤组织中ER,PR表达均低于对照组(P<0.01)。④两组肌层组织中ER,PR表达无明显差异(P>0.05)。结论小剂量米非司酮治疗子宫肌瘤效果明显,其治疗子宫肌瘤的机理可能是降调肌瘤局部的高ER,PR水平。Objective Observing the change of the positive rates of estrogen receptors（ER） ,progesten receptors（ PR） and microvessel density（ MVD} in human uterine leiomy-oma, myometrium, after mifepristone treatment ,to discuss the effects of low-dose of mifepristone on uterine leiomyoma. Methods Twenty patients with uterine myoma received 12.5mg of mifepristone daily for 90 days beginning on the first day of menstrual cycle. Hysterectomy was performed just when the treatment finished. Control group included 36 patients with normal menstrual cycle who had matched age,weight,size and position of leiomyoma （20 cases of proliferation stage, 16 cases of secretion stage ）. 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 analyses using monoclonal antibody. Leiomyomata microvessel density was counted in two groups. Results （1）The volume of uterine and the lagest myoma were significantly reduced after the treatment（ P 〈0.01）. （2）In control group ER and PR positive rate in leiomyoma were significantly higer than those of myometrium（ P 〈 0. 01 ）. （3）After 90 days of mifepristone treatment ER and PR positive rate in leiomyoma in study group were significantly less than those of control group （ P 〈0.01 ）. （4）ER and PR positive rate in myometrium of study group was similar to that of control group（ P 〉0.05 ）. Conclusion Mifepristone has significant effect in the treatment of uterine leiomyoma. 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：子宫肌瘤 米非司酮 雌、孕激素受体 

分 类 号：R737.33[医药卫生—肿瘤]