米非司酮与米索前列醇用于催经的研究  

Menstrual induction with mifepristone and misoprostol

作　　者：肖碧莲 赵珩 吴尚纯 Helena von Hertzen Gilda Piaggio 翁梨驹[3] 经小平[3] 程利南 任芳明 贺昌海 桂幼伦 雷贞武[6] 朱明辉[6] 曹小明[7] 汪蓉芬 丁婉华[8] 梅庆明 

机构地区：[1]国家计划生育委员会科学技术研究所,北京100081 [2]世界卫生组织生殖健康研究部 [3]首都医科大学附属北京朝阳医院,北京100020 [4]上海市计划生育指导所,上海200030 [5]上海市计划生育科研所,上海200032 [6]四川生殖卫生院,成都610041 [7]天津市计划生育研究所,天津300191 [8]江苏省计划生育科研所,南京210029 [9]广东省计划生育科研所,广州510080

出　　处：《生殖医学杂志》2003年第3期137-145,共9页Journal of Reproductive Medicine

基　　金：洛氏基金会赞助项目"米非司酮降低非意愿妊娠和人流的合作研究与开发"

摘　　要：目的　评估应用米非司酮联合米索前列醇催经的效果及副反应。　方法　在全国 8个研究中心共接收了 72 0名妇女 ,平均预期月经延迟 ( 4.9± 1 .7) d。接纳当天给予 1 50 mg米非司酮 ,3 6～ 48h后门诊阴道放置 40 0μg米索前列醇 ,并留院观察 1 h。嘱服药后 1 0 d内随诊。观察指标主要为妊娠、月经来潮。测定血清雌二醇 ( E2 )及孕酮 ( P) ,以分析月经延迟时的周期时相。　结果　在 72 0名妇女中失访 1人。在 71 9名妇女中 ,就诊时已经妊娠 492人 ,其中完全和不完全流产 46 7例 ( 95.0 % ) ;妊娠继续 2 4例 ( 4.9% ) ;异位妊娠 1例 ,作进一步处理。月经延迟 2 2 7名妇女 ,其中月经来潮 2 2 2例 ( 97.8% ) ;月经延迟>45d或停经者 5例 ( 2 .2 % )。服药后副反应中有恶心 9%、呕吐 3 .1 %。血清 E2 与 P显示 ,月经延迟者有 6 0 %仍处于卵泡期水平 ,仅 3 0 %处于黄体期 ;在妊娠组 ,6 0 %血清 P和E2 的水平相当于黄体期水平 ,说明已有极早期妊娠。　结论　米非司酮与米索前列醇联合应用是有效和安全的催经止孕方法 ,对解决妇女担忧非意愿妊娠有利 。Objective: To evaluate the efficacy and side effects of using mifepristone in combination with misoprostol for menstrual regulation. Subjects and methods: A total of 720 subjects were recruited in 8 centers in China. Women recruited had a delay of (4.9±1.7) days in average after the expected onset of menstruation. The subject was given a single dose of 150 mg mifepristone, followed 36~48 hours later 400 μg misoprostol by vaginally at the clinic. Follow-up visit was arranged about 10 days after treatment. The outcome measures were return of menstruation or early pregnancy terminated. Serum levels of estradiol (E 2)and progesterone (P) levels were measured to evaluate the status of menstrual phase. Results: One case was lost to follow-up. Among 719 subjects 492 were pregnant at admission, pregnancy terminated (complete and incomplete) in 467 (95%), and pregnancy continued with further treatment in 24 (4.9%). There was one case of ectopic pregnancy. 227 women had delay of menstruation: menstruation was induced in 222 (97.8%), menstruation not induced >45 days or amenorrhea in 5 (2.2%) Over 9% of women had nausea and 5% had vomiting. Serum E 2 and P levels indicate that over 60% of the delayed menses were in the follicular phase and over 30% in the luteal phase levels. In the pregnant group E 2 and P levels were in the luteal phase levels, which may indicate very early stage of pregnancy. Conclusion: Mifepristone in combination with misoprostol is an effective and safe method for menstrual regulation, which will relieve many women from the anxiety of unwanted pregnancy and save them from seeking abortion in a later stage.

关 键 词：催经 米非司酮 米索前列醇 雌二醇 孕酮 

分 类 号：R169.42[医药卫生—公共卫生与预防医学]