米非司酮联合他莫昔芬治疗子宫肌瘤的效果及对患者性激素和炎症因子水平的影响  

The effect of mifepristone combined with tamoxifen in the treatment of uterine fibroids and its influence on the level of sex hormone and inflammatory factor

作　　者：李玮 朱根海[1] 吴秀荣[1] 张静[2] 游德红 Li Wei;Zhu Genhai;Wu Xiurong;Zhang Jing;You Dehong(Department of Gynecology,Hainan Provincial People's Hospital,Haikou 570000,China;Department of Gynecology,the Second Affiliated Hospital of Shaanxi University of Chinese Medicine,Shaanxi Province,Xianyang 712000,China;Department of Laboratory,Pidu District People's Hospital,Chengdu 611730,China)

机构地区：[1]海南省人民医院妇科,海口570000 [2]陕西中医药大学第二附属医院妇科,陕西省咸阳市712000 [3]成都市郫都区人民医院检验科,611730

出　　处：《中国医药》2020年第11期1753-1756,共4页China Medicine

基　　金：四川省医学科学研究重点课题计划(18PJ108)。

摘　　要：目的分析米非司酮联合他莫昔芬治疗子宫肌瘤的效果及对患者性激素和炎症因子水平的影响。方法选择2017年7月至2019年5月海南省人民医院妇科收治的子宫肌瘤患者80例,采用随机数字表法分为对照组和观察组,各40例。对照组口服米非司酮进行治疗,观察组在对照组的基础上联合他莫昔芬口服治疗,2组均治疗3个月。比较2组子宫和子宫肌瘤情况、血清性激素水平、炎症因子水平和不良反应发生情况。结果治疗3个月后和停药3个月后,2组子宫体积、子宫肌瘤体积和血清卵泡刺激素、雌激素、孕酮水平较治疗前呈逐渐降低趋势,且观察组显著低于对照组[停药3个月后子宫体积、子宫肌瘤体积:(106±12)cm3比(113±13)cm^3、(30±12)cm3比(34±10)cm^3],差异均有统计学意义(均P<0.05)。2组治疗3个月后血清高敏C反应蛋白、白细胞介素6水平均低于治疗前,且观察组低于对照组[(1.4±0.6)mg/L比(2.7±1.2)mg/L、(50±21)ng/L比(92±34)ng/L],差异均有统计学意义(均P<0.05)。观察组与对照组不良反应发生率差异无统计学意义[7.5%(3/40)比10.0%(4/40)](P>0.05)。结论米非司酮联合他莫昔芬治疗子宫肌瘤能显著改善患者性激素水平,降低机体炎症反应,减小患者子宫肌瘤体积。Objective To analyze the effect of mifepristone combined with tamoxifen in the treatment of uterine fibroids and its influence on the level of sex hormone and inflammatory factor.Methods Eighty patients with uterine fibroids admitted to the department of gynecology of Hainan Provincial People's Hospital from July 2017 to May 2019 were selected and divided into control group and observation group according to random number table method,with 40 cases in each group.The control group was treated with mifepristone orally,and the observation group was treated with tamoxifen orally on the basis of control group.Both groups were treated for 3 months.The status of uterine and uterine fibroids,serum sex hormone levels,inflammatory factor levels and the occurrence of adverse reactions were compared between the two groups.Results After 3 months of treatment and 3 months of discontinuation,the volume of uterine and uterine fibroids,serum follicle stimulating hormone,estrogen and progesterone levels in the two groups decreased gradually compared with those before treatment,and those in observation group were lower than those in control group[uterine volume and unterine fibroids volume after 3 months of discontinuation:(106±12)cm^3 vs(113±13)cm^3,(30±12)cm^3 vs(34±10)cm3],the differences were statistically significant(all P<0.05).After 3 months of treatment,the serum high-sensitivity C-reactive protein and interleukin-6 levels in the two groups were lower than those before treatment,and those in observation group were lower than those in control group[(1.4±0.6)mg/L vs(2.7±1.2)mg/L,(50±21)ng/L vs(92±34)ng/L],the differences were statistically significant(all P<0.05).There was no significant difference in the incidence of adverse reactions between the two group[7.5%(3/40)vs 10.0%(4/40)](P>0.05).Conclusion Mifepristone combined with tamoxifen in the treatment of uterine fibroids can significantly improve the sex hormone levels,reduce the body's inflammatory response and reduce the volume of uterine fibroids.

关 键 词：子宫肌瘤 他莫昔芬 米非司酮 卵泡刺激素 黄体生成素 

分 类 号：R733.33[医药卫生—肿瘤]