米非司酮终止妊娠作用机制的研究进展  

Review on mechanism of termination of pregnancy by mifepristone

作　　者：杨倩[1] 王健[1,2] 孙兆贵[1,2] 

机构地区：[1]复旦大学上海医学院,生殖与发育研究院,上海200032 [2]国家人口和计划生育委员会计划生育药具重点实验室,上海市计划生育科学研究所,上海200032

出　　处：《生殖与避孕》2015年第8期561-565,共5页Reproduction and Contraception

基　　金：上海市科学技术委员会科研计划项目,项目编号为13140901300

摘　　要：米非司酮(mifepristone,RU486)是国际上第一个上市的用于终止妊娠的药物,不仅已被临床用于终止早期和中期妊娠,而且在终止中晚期妊娠方面也有潜在的临床应用前景。通过综述有关文献得出,作为孕激素受体和糖皮质激素受体拮抗剂,米非司酮影响母-胎界面局部的免疫细胞分化和功能,蜕膜和绒毛细胞外基质重构,母-胎界面各种细胞凋亡等生理过程,诱发母-胎界面免疫耐受状态失衡,作为导致妊娠终止的主要机制。另外,米非司酮还通过影响子宫颈结缔组织分解和子宫平滑肌收缩等方式阻止妊娠。借助动物模型和临床数据,全面解析米非司酮的作用机制是未来研究的趋势。As the first commercial drugs in the world for termination of pregnancy, mifepristone （RU486） not only has been clinically used for termination of early and mid-term pregnancy, but also has prospects for clinical application in termination of late-term pregnancy. By reviewing recent literatures, as an progesterone and gluco- corticoid receptor antagonist, mifepristone can interfere with the local immune state of maternal-fetal interfaces, result in extracellular matrix remodeling in chorionic villi and decidua, and apoptosis of cells at maternal-fetal interfaces so to break up immune tolerance state at maternal-fetal interfaces, eventually to lead to pregnancy termination as its involved key mechanism, other than its promotion effect in cervical connective tissue decomposition and uterine cervix smooth muscle contraction. With the help of animal model and clinical data, a compre-hensive analysis on its mechanism will be in the trend of future research.

关 键 词：米非司酮 蜕膜 绒毛 细胞凋亡 流产 

分 类 号：R169.42[医药卫生—公共卫生与预防医学]