小剂量米非司酮联合孕三烯酮治疗围绝经期子宫肌瘤患者的效果及对血清性激素指标的影响探讨  

Effect of low-dose mifepristone combined with gestrinone in the treatment of perimenopausal uterine fibroids and its influence on serum sex hormone indexes

作　　者：王艳丹 WANG Yan-dan(Department of Gynecology,Yutai County People's Hospital,Jining 272300,China)

机构地区：[1]鱼台县人民医院妇科,272300

出　　处：《中国实用医药》2025年第2期139-142,共4页China Practical Medicine

摘　　要：目的观察小剂量米非司酮联合孕三烯酮治疗围绝经期子宫肌瘤患者的效果及对其血清性激素指标的影响。方法围绝经期子宫肌瘤患者67例,根据治疗方案的差异将其分成对照组(32例)与观察组(35例)。对照组以孕三烯酮作为治疗方案,观察组以小剂量米非司酮联合孕三烯酮作为治疗方案。比较两组临床疗效、不良反应发生率及治疗前后血清性激素指标、子宫内膜厚度、子宫体积、子宫肌瘤体积、临床症状评分。结果与对照组的62.50%比较,观察组治疗总有效率88.57%显著更高(P<0.05)。治疗后,两组雌二醇、孕酮、卵泡刺激素、黄体生成素水平显著低于治疗前,且观察组雌二醇(160.79±10.35)pmol/L、孕酮(16.33±2.17)μg/L、卵泡刺激素(19.76±2.24)U/L、黄体生成素(15.60±1.73)U/L显著低于对照组的(182.10±15.63)pmol/L、(20.86±2.50)μg/L、(23.48±3.59)U/L、(19.94±2.12)U/L(P<0.05)。治疗后,两组子宫内膜厚度、子宫体积、子宫肌瘤体积显著小于治疗前,且观察组子宫内膜厚度(6.93±1.03)mm、子宫体积(153.48±21.72)cm^(3)、子宫肌瘤体积(45.92±6.63)cm^(3)显著小于对照组的(8.15±1.35)mm、(205.45±36.31)cm^(3)、(56.01±8.46)cm^(3)(P<0.05)。治疗后,两组月经增多、下腹包块、排尿障碍评分显著低于治疗前,且观察组月经增多评分(1.27±0.10)分、下腹包块评分(1.68±0.20)分、排尿障碍评分(1.31±0.12)分显著低于对照组的(2.19±0.16)、(2.35±0.27)、(2.46±0.18)分(P<0.05)。与对照组的2.86%比较,观察组不良反应发生率18.75%显著更低(P<0.05)。结论在围绝经期子宫肌瘤治疗过程中,对患者应用小剂量米非司酮与孕三烯酮联合治疗具备较高的推广价值,该治疗方案可提高患者的临床疗效,改善临床症状及血清性激素指标,利于子宫的恢复。Objective To observe the effect of low-dose mifepristone combined with gestrinone in the treatment of perimenopausal uterine fibroids and its influence on serum sex hormone indexes.Methods 67 patients with perimenopausal uterine fibroids were divided into control group(32 cases)and observation group(35 cases)according to the difference in treatment regimens.The control group was treated with gestrinone,and the observation group was treated with low-dose mifepristone combined with gestrinone.Comparison was made on clinical efficacy,incidence of adverse reactions,serum sex hormone indexes,endometrial thickness,uterine volume,uterine fibroid volume and clinical symptom score before and after treatment between the two groups.Results Compared with 62.50% in the control group,the total effective rate of the observation group was significantly higher at 88.57%(P<0.05).After treatment,the levels of estradiol,progesterone,follicle stimulating hormone and luteinizing hormone in both groups were significantly lower than those before treatment;the levels of estradiol,progesterone,follicle stimulating hormone and luteinizing hormone in the observation group were(160.79±10.35)pmol/L,(16.33±2.17)μg/L,(19.76±2.24)U/L and(15.60±1.73)U/L,which were significantly lower than(182.10±15.63)pmol/L,(20.86±2.50)μg/L,(23.48±3.59)U/L and(19.94±2.12)U/L in the control group(P<0.05).After treatment,the endometrial thickness,uterine volume and uterine fibroid volume in both groups were significantly smaller than those before treatment;in the observation group,the endometrial thickness was(6.93±1.03)mm,the uterine volume was(153.48±21.72)cm^(3),and the uterine myoma volume was(45.92±6.63)cm^(3),which were significantly smaller than(8.15±1.35)mm,(205.45±36.31)cm^(3) and(56.01±8.46)cm^(3) in the control group(P<0.05).After treatment,the scores of increased menstrual volume,lower abdominal mass and dysuria in both groups were significantly lower than those before treatment;the scores of increased menstrual volume,lower abdominal m

关 键 词：米非司酮 孕三烯酮 围绝经期子宫肌瘤 血清性激素 临床疗效 

分 类 号：R73[医药卫生—肿瘤]