不同方案甲氨蝶呤联合米非司酮治疗异位妊娠患者的效果比较  

with mifepristone in the treatment of ectopic pregnancy patients

作　　者：段凤鸽 刘航娟 董香玉 DUAN Fengge;LIU Hangjuan;DONG Xiangyu(Xianyang Rainbow Hospital,Xianyang 712000;Xi'an People's Hospital/Xi'an Fourth Hospital,Xi'an 710004,China)

机构地区：[1]咸阳彩虹医院,陕西咸阳712000 [2]西安市人民医院/西安市第四医院,陕西西安710004

出　　处：《临床医学研究与实践》2023年第25期82-85,共4页Clinical Research and Practice

摘　　要：目的比较不同方案甲氨蝶呤(MTX)联合米非司酮(Ru486)治疗异位妊娠患者的效果。方法选取2017年7月至2020年7月诊治的68例异位妊娠患者为研究对象,通过双盲法将其分为对照组和观察组,各34例。对照组实施MTX 50 mg/m^(2)单次肌肉注射+Ru486治疗,观察组实施MTX 0.4 mg/(kg·d)连续5 d肌肉注射+Ru486治疗。比较两组的治疗效果。结果治疗4、7 d后,两组的抑制素A(INH-A)水平均明显低于治疗前,且观察组低于对照组,差异具有统计学意义(P<0.05)。治疗2周后,两组的β-人绒毛膜促性腺激素(β-HCG)、孕酮(P)、白细胞介素-8(IL-8)及肿瘤坏死因子-α(TNF-α)水平明显低于治疗前,且观察组低于对照组,差异具有统计学意义(P<0.05)。观察组的月经恢复时间、包块消失时间、腹痛消失时间、阴道出血消失时间均短于对照组,差异具有统计学意义(P<0.05)。结论MTX 0.4 mg/(kg·d)连续5 d肌肉注射联合Ru486方案在异位妊娠患者治疗中的效果较好,能够显著降低INH-A、β-HCG、P、IL-8及TNF-α水平,缩短月经恢复时间、包块消失时间、腹痛消失时间及阴道出血消失时间,值得临床推广及应用。Objective To compare the effects of different regimen of methotrexate(MTX)combined with mifepristone(Ru486)in the treatment of ectopic pregnancy patients.Methods A total of 68 ectopic pregnancy patients diagnosed and treated from July 2017 to July 2020 were selected as the research objects,and the patients were divided into control group and observation group by double-blind method,with 34 cases in each group.The control group was treated with single intramuscular injection of MTX 50 mg/m^(2)+Ru486,and the observation group was treated with intramuscular injection of MTX 0.4 mg/(kg·d)for consecutive 5 d+Ru486.The therapeutic effects of the two groups were compared.Results After 4 and 7 d of treatment,the levels of inhibin A(INH-A)in the two groups were significantly lower than those before treatment,those in the observation group were lower than the control group,and the differences were statistically significant(P<0.05).After 2 weeks of treatment,the levels ofβ-human chorionic gonadotophin(β-HCG),progesterone(P),interleukin-8(IL-8)and tumor necrosis factor-α(TNF-α)in the two groups were significantly lower than those before treatment,those in the observation group were lower than the control group,and the differences were statistically significant(P<0.05).The menstrual recovery time,mass disappearance time,abdominal pain disappearance time and vaginal bleeding disappearance time in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).Conclusion Intramuscular injection of MTX 0.4 mg/(kg·d)for consecutive 5 d combined with Ru486 regimen has a good effect in the treatment of ectopic pregnancy patients,it can significantly reduce the levels of INH-A,β-HCG,P,IL-8 and TNF-α,and shorten the menstrual recovery time,mass disappearance time,abdominal pain disappearance time and vaginal bleeding disappearance time,which is worthy of clinical promotion and application.

关 键 词：甲氨蝶呤 米非司酮 异位妊娠 抑制素A Β-人绒毛膜促性腺激素 

分 类 号：R714.22[医药卫生—妇产科学]