米非司酮对子宫肌瘤和子宫腺肌病的影响  

The effect of RU_(486) to uterine leiomyomata and adenomyosis

作　　者：骆永凤[1] 孙景礼 范丽环[1] 刘铁力[3] 赵春华[4] 步春游 秦丽洁[5] 滕红[6] 

机构地区：[1]吉林长春市中心医院妇产科,130051 [2]吉林长春市中心医院药剂科,130051 [3]吉林长春市中心医院电诊科,130051 [4]吉林长春市中心医院,放免130051 [5]长春市妇幼保健所 [6]白求恩医科大学第二临床学院

出　　处：《中国基层医药》2002年第2期129-131,共3页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的　探讨米非司酮对子宫肌瘤与子宫腺肌病的作用机制及临床治疗效果。方法　选择门诊病人 ,子宫肌瘤病人 5 0例 ,全部为壁间肌瘤 ,其直径为 3～ 7cm ,子宫腺肌病 10例。按年龄段分成四组 ,月经干净后第 3天开始口服米非司酮 2 5mg ,日服 1次 ,连续服用 3个月 ,观察肌瘤大小的变化。此外 ,采用多点法测定子宫肌瘤、子宫腺肌病及正常子宫肌层组织中孕激素受体含量。结果　子宫肌瘤体积于用药第 4周开始下降 ,平均下降了 19% (19%± 3 6 % ) ,第 8周平均下降了 39 3% (39 3 %± 5 4% ) ,至 12周明显下降 ,平均下降了 48 6 % (48 6 %± 8 7% ) ,统计学处理 ,差异有显著意义 (P <0 0 0 1)。从个别病例上观察仅有 3例无变化 ,而 4例体积下降 72 %。各组间差异无显著意义。子宫腺肌病病人子宫体积平均减少了 17 6 % ,统计学处理差异有显著意义 (P <0 0 5 ) ,临床症状减轻或消失。服药 3个月后追踪 2 0例病人 (18例子宫肌瘤 ,2例子宫腺肌病 ) ,子宫彩超检查显示 ,子宫与子宫肌瘤体积无增大趋势。子宫肌瘤与子宫腺肌病病人子宫肌层组织内的孕激素受体含量高于正常的子宫肌层组织。结论　子宫肌瘤组织与子宫腺肌病病人子宫肌层组织孕激素受体表达高于正常子宫肌层组织 ,米非司酮阻断孕激素作用 。Objective To investigate the effective theory and chinical efficacy of RU 486 in the treatment of uterine leiomyomata and adnomyosis.Methods Sixty out patients were given RU 486 25mg/d for 3 months begining on day 3 of the menstrual cycle.Fifty uterine leiomyomata women all have had leiomyoma in tunica muscularis uteri.Ten patients were adenomyosis women.They were devided into four groups.In addition,Lowy's methad in used to detect PR levels in uterine leiomyomata a denomyosis and uterns.Results Leiomyomata volume decreased 19%(19%±3.6%) after 4 weeks,39.3%(39.3%±5.4%) after 8 weeks,48.6%(48.6%±8.7%) after 12 weeks(P<0.01).Chnical symptoms of aderomyosis patients relieved or disppeared and uterine volume decreased 17.6%(P<0.05).Tmenty cases were followed uped after 3 months,including eigteen cases of utrine leiomyomata and two cases of adomyosis.PR lvevls of uterine leiomyomata and adenomyosis is higher than normal uterus.Conclusion PR levels of uterine leiomyomata and adenomyosis is higher than normal.RU 486 effect the numbers of PR in target tissue and block the effect of gestageno,and make clinical symptoms of adenomyosis women to rehered or disppeared.

关 键 词：子宫肌瘤 子宫腺肌病 米非司酮 孕激素受体 作用机制 临床疗效 

分 类 号：R737.33[医药卫生—肿瘤]