氨甲喋呤应用于早孕药流的研究  

Study of Methotrexate for Early Medicinal Abortion

作　　者：王红[1] 毛尔一[1] 刘庆喜[1] 

机构地区：[1]上海第二医科大学新华医院妇产科,上海200092

出　　处：《上海交通大学学报（医学版）》2000年第S1期34-36,39,共4页Journal of Shanghai Jiao tong University:Medical Science

摘　　要：目的探讨氨甲喋呤在早孕药物流产中的作用。　方法 5 6 2例早孕妇女按孕囊平均直径分为 <1 5mm、1 5～ 2 5mm ,>2 5mm组。 30 2例在米非司酮和米索前列醇基础上分别加用 30、45、6 0mg氨甲喋呤 (methotrex ate,MTX)。 2 6 0例为对照组 ,仅服用米非司酮和米索前列醇。　结果在 <1 5mm组 ,对照组与实验组的药物流产成功率无显著性差异 (P >0 .0 5 ) ;1 5～ 2 5mm组 ,实验组成功率明显高于对照组 (P <0 .0 5 ) ,MTX 3剂量组间则无显著性差异 (P>0 .0 5 ) ;>2 5mm组 ,实验组成功率均为 1 0 0 % ,而对照组为 85 .71 %。 3组合计与对照组有显著性差异(P<0 .0 5 )。MTX 3组未见严重副反应。　结论米非司酮和米索前列醇加用MTX ,可显著提高较大孕囊的早孕药物流产成功率。小剂量MTX对健康妇女是安全的。Objective To study the effect of oral low-dose MTX combined with mifepristone and misoprostol in the medicinal abortion of early pregnancy. Methods 562 cases of early pregnancy women were divided into 3 groups according to the average diameter of the blastocysts <15mm ,15～25mm and>25mm determined by B mode ultrasound. The whole series took mifepristone and misoprostol. Additionally, 54 cases took MTX 30mg, 76, 45mg, and 172, 60mg. Results there was no significant difference on the rate of complete abortion in 3 MTX groups and control group with <15mm (P>0.05). The rate of complete abortion of 3 MTX groups was significant higher than in control group with 15～25mm (P<0.05), but there was no significant difference among 3 MTX groups (P>0.05). The rate of complete abortion of 3 MTX groups was 100% and that of control group was 85.71% with 25mm. There was significant difference between control group and the 3 MTX groups. The adverse effects of MTX were few. WBC count was normal but slightly dropped after 2 weeks. Conclusion MTX combined with mifepristone and misoprostol can increase the rate of comptete abortion when the average diameter of the blastocyst>15mm. Low dose of MTX is safe.

关 键 词：氨甲喋呤 早孕 药物流产 

分 类 号：R169.42[医药卫生—公共卫生与预防医学]