雌-孕激素序贯治疗对米非司酮、米索前列醇药物流产后出血患者卵巢功能的影响  

Effects of sequential therapy of estrogen and progesterone on ovarian function in bleeding patients after drug abortion by mifepristone and misoprostol

作　　者：戴小萍[1] DAI Xiao-ping(Department of Gynaecology and Obstetrics, Hainan Traditional Chinese Medicine Hospital, Hainan Haikou 570203, Chin)

机构地区：[1]海南省中医院妇产科,海南海口570203

出　　处：《中国医院药学杂志》2018年第13期1415-1418,共4页Chinese Journal of Hospital Pharmacy

基　　金：海南省自然科学基金项目(编号:1426360.10A1006)

摘　　要：目的:探讨雌-孕激素序贯治疗对米非司酮、米索前列醇药物流产后出血患者卵巢功能的影响。方法:选取2013年1月-2015年12月某院行米非司酮、米索前列醇药物流产后出血患者88例,按照随机数字法分为2组,对照组采用预防感染、止血治疗,研究组采用雌-孕激素序贯疗法。治疗后对所有患者的阴道出血量和阴道出血时间进行评价;收集血液样本,测定卵巢功能和血管生成调节因子,记录临床观察指标和不良反应事件。结果:对照组出血过少率34.09%和出血时间短率38.64%低于研究组61.36%、63.64%(P<0.05);与治疗前比,两组治疗后血清E2数值升高,P数值降低,血浆VEGF、Ang-1、Ang-2数值降低(P<0.05);与对照组比,研究组治疗后血清E2数值较高,P数值较低,血浆VEGF、Ang-1、Ang-2数值较低(P<0.05),月经复潮时间较低,子宫内膜厚度较高(P<0.05);对照组不良率25%和研究组不良率13.64%对比无差异(P>0.05)。结论:雌-孕激素序贯对于米非司酮、米索前列醇药物流产后出血患者的止血效果确切,促进卵巢功能恢复,降低血管生成调节因子,不良反应小,值得临床上推广应用。OBJECTIVE To investigate the effect of sequential therapy of estrogen and progesterone on ovarian function in bleeding patients after drug abortion by mifepristone and misoprostol.METHODS Totally 88 cases of bleeding induced by mifepristone and misoprostol in our hospital from January 2013 to December 2015 were randomly divided into 2 groups by the random number method.Patients in the control group were treated with infection prevention and hemostasis,and patients in the study group were treated with estrogen and progesterone sequential therapy.The vaginal bleeding volume and time were evaluated in all patients,blood samples were collected,ovarian function and angiogenic regulatory factors were measured,and clinical observations and adverse events were recorded.RESULTS The rate of less bleeding and short term bleeding were34.09% and 38.64%in the control group,61.36% and 63.64%in the stud group（P0.05）.Compared with those before treatment,the serum E2 value increased,the P value decreased,and the plasma VEGF,Ang-1 and Ang-2 decreased in two groups（P0.05）.Compared with the control group,the serum E2 value of the treatment group was higher,the P value was lower,and the plasma VEGF,Ang-1 and Ang-2 values were lower（P〈0.05）,time of menstruation is shorter and the endometrial thickness was higher（P〈0.05）.The adverse rate in the control group was 25% and in study group was 13.64%（P〈0.05）.CONCLUSION Estrogen progestin sequential therapy for hemostasis in patients with bleeding after medical abortion with mifepristone and misoprostol is effective,can promote the recovery of ovarian function,reduce angiogenic factor and adverse reactions,and is worthy of clinical application.

关 键 词：雌-孕激素 药物流产 阴道出血 卵巢功能 血管生成调节因子 

分 类 号：R979.2[医药卫生—药品]