不同剂量米非司酮对子宫肌瘤患者激素水平及不良反应发生情况的影响研究
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摘要
目的:探讨观察不同剂量米非司酮对子宫肌瘤患者激素水平及不良反应发生情况的影响。方法:选取2016年2月-2017年9月深圳市妇幼保健院诊治的62例子宫肌瘤患者作为研究对象,所有患者均经妇科检查或者B超确诊。按照随机数字表法将其分为高剂量组和低剂量组,各31例。高剂量组给予50 mg米非司酮进行治疗,低剂量组给予12.5 mg米非司酮治疗。比较两组激素水平、临床疗效以及不良反应发生情况。结果:治疗后,低剂量组总有效率为93.55%,明显优于高剂量组的74.19%,差异有统计学意义(X~2=4.292 3,P=0.038 3)。治疗后两组性激素水平较治疗前均有显著改善;低剂量组改善水平较高剂量组更为显著,差异均有统计学意义(P<0.05)。治疗后两组患者的子宫肌瘤体积较治疗前均明显缩小,且低剂量组明显优于高剂量组,差异均有统计学意义(P<0.05)。在用药期间,低剂量组不良反应发生率为9.68%,低于高剂量组为32.26%,差异有统计学意义(X~2=4.769 2,P=0.029 0),经及时对症处理后症状均消失,无严重不良反应发生。结论:应用低剂量米非司酮治疗子宫肌瘤临床效果更加显著,可改善患者激素水平,且安全性高,无明显不良反应,值得临床应用和推广。
Objective:To investigate the effects of different doses of Mifepristone on the hormone levels and adverse reactions in patients with uterine fibroids.Method:A total of 62 patients with uterine fibroids treated from February 2016 to September 2017 in Shenzhen Maternal and Child Health Care Hospital were selected as the study objects.All patients were diagnosed by gynecological examination or B-ultrasound.According to the random number table method,they were divided into high-dose group and low-dose group,31 cases in each group.The high-dose group was treated with 50 mg of Mifepristone,the low-dose group was given 12.5 mg of Mifepristone.The hormone level,clinical efficacy and adverse reactions between the two groups were compared.Result:After treatment,the total effective rate of the low-dose group was 93.55%,which was significantly higher than 74.19% of the high-dose group,the difference was statistically significant( X~2=4.292 3,P=0.038 3).After treatment,the levels of sex hormones in two groups were significantly improved compared with those before treatment,and the improvement levels in the low-dose group was more significant than those in the high-dose group,the differences were statistically significant(P<0.05).After treatment,the volume of uterine fibroids in two groups was significantly smaller than that before treatment,and the low-dose group was better than the high-dose group,the differences were statistically significant(P<0.05).During the period of medication,the incidence of adverse reactions was 9.68% in the low-dose group,which was lower than 32.26% in the high-dose group,the difference was statistically significant( X~2=4.769 2,P=0.029 0),the symptoms disappeared and no serious adverse reactions occurred after prompt treatment.Conclusion:The application of low dose of Mifepristone in the treatment of uterine fibroids is more effective,it can improve the hormone levels in patients with high safety and no obvious adverse reactions,which is worthy of clinical application and promotion.
Objective:To investigate the effects of different doses of Mifepristone on the hormone levels and adverse reactions in patients with uterine fibroids.Method:A total of 62 patients with uterine fibroids treated from February 2016 to September 2017 in Shenzhen Maternal and Child Health Care Hospital were selected as the study objects.All patients were diagnosed by gynecological examination or B-ultrasound.According to the random number table method,they were divided into high-dose group and low-dose group,31 cases in each group.The high-dose group was treated with 50 mg of Mifepristone,the low-dose group was given 12.5 mg of Mifepristone.The hormone level,clinical efficacy and adverse reactions between the two groups were compared.Result:After treatment,the total effective rate of the low-dose group was 93.55%,which was significantly higher than 74.19% of the high-dose group,the difference was statistically significant( X~2=4.292 3,P=0.038 3).After treatment,the levels of sex hormones in two groups were significantly improved compared with those before treatment,and the improvement levels in the low-dose group was more significant than those in the high-dose group,the differences were statistically significant(P<0.05).After treatment,the volume of uterine fibroids in two groups was significantly smaller than that before treatment,and the low-dose group was better than the high-dose group,the differences were statistically significant(P<0.05).During the period of medication,the incidence of adverse reactions was 9.68% in the low-dose group,which was lower than 32.26% in the high-dose group,the difference was statistically significant( X~2=4.769 2,P=0.029 0),the symptoms disappeared and no serious adverse reactions occurred after prompt treatment.Conclusion:The application of low dose of Mifepristone in the treatment of uterine fibroids is more effective,it can improve the hormone levels in patients with high safety and no obvious adverse reactions,which is worthy of clinical application and promotion.
引文
[1]蔡兴苑,卢丹,魏薇,等.子宫肌瘤剔除术后复发情况及相关危险因素分析[J].实用妇产科杂志,2015,31(5):358-360.
[2]潘春燕,张印星,陈小刚.不同剂量米非司酮对子宫肌瘤患者临床疗效及血清学影响分析[J].河北医药,2016,38(12):1782-1785.
[3]Chandran S,Cairns M T,O’Brien M,et al.Effects of combined progesterone and 17β-estradiol treatment on the transcriptome of cultured human myometrial smooth muscle cells[J].Physiological Genomics,2016,48(1):50-61.
[4]陈娟.米非司酮联合中药宫瘤消对子宫肌瘤患者细胞因子和性激素水平影响研究[J].临床和实验医学杂志,2016,15(14):1428-1431.
[5]朱晓兰,李洁明.米非司酮联合宫瘤消胶囊对子宫肌瘤患者细胞因子和性激素水平影响研究[J].中国性科学,2016,25(4):56-59.
[6]Park H,Yoon S W,Sokolov A.Scaled signal intensity of uterine fibroids based on T2-weighted MR images:a potential objective method to determine the suitability for magnetic resonanceguided focused ultrasound surgery of uterine fibroids[J].European Radiology,2015,25(12):3455-3458.
[7]高艳民,孙小芳,刘连臣,等.小剂量米非司酮对子宫肌瘤患者雌、孕激素水平、子宫及瘤体体积的影响[J].检验医学与临床,2017,14(20):3058-3060.
[8]Lee H Y,Ko A R,Kang D W,et al.Abstract 1191:Anti-tumor effect of selective progesterone receptor modulator(ulipristal acetate)on endometrial cancer cell lines[J].Cancer Research,2016,76(14 Supplement):1191.
[9]宋芳.中药消瘤汤配伍米非司酮对子宫肌瘤患者子宫及肌瘤体积及激素指标水平的影响[J].现代中西医结合杂志,2016,25(14):1558-1560.
[10]Sant’Anna G D S,Brum I S,Branchini G,et al.Ovarian steroid hormones modulate the expression of progesterone receptors and histone acetylation patterns in uterine leiomyoma cells[J].Gynecological Endocrinology,2017,33(8):629-633.
[11]何丽琼,王群,贾蜀云,等.不同剂量米非司酮治疗围绝经期子宫小肌瘤临床效果及对血管内皮生长因子和其受体表达的影响[J].临床误诊误治,2016,5(2):81-83.
[12]周绵莉,毛惠,喻小兰,等.桂枝茯苓胶囊联合米非司酮治疗子宫肌瘤的疗效及对血清VEGF、ER和PR水平的影响[J].中国肿瘤临床与康复,2017,9(8):971-974.
[13]Lee J S,Hong G Y,Park B J,et al.Ultrasound-guided highintensity focused ultrasound treatment for uterine fibroid&adenomyosis:a single center experience from the Republic of Korea[J].Ultrasonics Sonochemistry,2015,27:682-687.
[14]李清阳,刘海,张颖.血腑逐瘀汤辅助治疗子宫肌瘤的疗效及对患者LH、E2、FSH水平的影响[J].中国妇幼保健,2017,32(20):4942-4944.
[15]Chaudhury S,Hazlerigg A,Nguyen J,et al.Lower limb surface pressures generated by different types of immobilization casts[J].Injury-international Journal of the Care of the Injured,2015,46(8):1430.
[16]丛小红,张玉梅,赵亚芹.子宫肌瘤剔除术后辅用米非司酮联合香棱丸加味对复发率及血清性激素的影响[J].现代中西医结合杂志,2016,25(23):2556-2558.
[17]张莉.桂枝茯苓丸联合米非司酮治疗子宫肌瘤的疗效及对激素水平和血液流变学的影响[J].现代中西医结合杂志,2016,25(2):172-174.
[18]Aluwee S A,Kato H,Zhou X,et al.Magnetic resonance imaging of uterine fibroids:a preliminary investigation into the usefulness of 3D-rendered images for surgical planning[J].Springerplus,2015,4(1):384.
[19]江飞云,倪观太.逍遥丸联合米非司酮治疗肝郁血虚脾弱型子宫肌瘤的临床疗效[J].中国现代医学杂志,2016,26(24):97-100.
[20]方海娅,张海燕,寿华锋.米非司酮治疗围绝经期子宫肌瘤的临床研究[J].中国临床药理学杂志,2016,32(11):987-989.
[2]潘春燕,张印星,陈小刚.不同剂量米非司酮对子宫肌瘤患者临床疗效及血清学影响分析[J].河北医药,2016,38(12):1782-1785.
[3]Chandran S,Cairns M T,O’Brien M,et al.Effects of combined progesterone and 17β-estradiol treatment on the transcriptome of cultured human myometrial smooth muscle cells[J].Physiological Genomics,2016,48(1):50-61.
[4]陈娟.米非司酮联合中药宫瘤消对子宫肌瘤患者细胞因子和性激素水平影响研究[J].临床和实验医学杂志,2016,15(14):1428-1431.
[5]朱晓兰,李洁明.米非司酮联合宫瘤消胶囊对子宫肌瘤患者细胞因子和性激素水平影响研究[J].中国性科学,2016,25(4):56-59.
[6]Park H,Yoon S W,Sokolov A.Scaled signal intensity of uterine fibroids based on T2-weighted MR images:a potential objective method to determine the suitability for magnetic resonanceguided focused ultrasound surgery of uterine fibroids[J].European Radiology,2015,25(12):3455-3458.
[7]高艳民,孙小芳,刘连臣,等.小剂量米非司酮对子宫肌瘤患者雌、孕激素水平、子宫及瘤体体积的影响[J].检验医学与临床,2017,14(20):3058-3060.
[8]Lee H Y,Ko A R,Kang D W,et al.Abstract 1191:Anti-tumor effect of selective progesterone receptor modulator(ulipristal acetate)on endometrial cancer cell lines[J].Cancer Research,2016,76(14 Supplement):1191.
[9]宋芳.中药消瘤汤配伍米非司酮对子宫肌瘤患者子宫及肌瘤体积及激素指标水平的影响[J].现代中西医结合杂志,2016,25(14):1558-1560.
[10]Sant’Anna G D S,Brum I S,Branchini G,et al.Ovarian steroid hormones modulate the expression of progesterone receptors and histone acetylation patterns in uterine leiomyoma cells[J].Gynecological Endocrinology,2017,33(8):629-633.
[11]何丽琼,王群,贾蜀云,等.不同剂量米非司酮治疗围绝经期子宫小肌瘤临床效果及对血管内皮生长因子和其受体表达的影响[J].临床误诊误治,2016,5(2):81-83.
[12]周绵莉,毛惠,喻小兰,等.桂枝茯苓胶囊联合米非司酮治疗子宫肌瘤的疗效及对血清VEGF、ER和PR水平的影响[J].中国肿瘤临床与康复,2017,9(8):971-974.
[13]Lee J S,Hong G Y,Park B J,et al.Ultrasound-guided highintensity focused ultrasound treatment for uterine fibroid&adenomyosis:a single center experience from the Republic of Korea[J].Ultrasonics Sonochemistry,2015,27:682-687.
[14]李清阳,刘海,张颖.血腑逐瘀汤辅助治疗子宫肌瘤的疗效及对患者LH、E2、FSH水平的影响[J].中国妇幼保健,2017,32(20):4942-4944.
[15]Chaudhury S,Hazlerigg A,Nguyen J,et al.Lower limb surface pressures generated by different types of immobilization casts[J].Injury-international Journal of the Care of the Injured,2015,46(8):1430.
[16]丛小红,张玉梅,赵亚芹.子宫肌瘤剔除术后辅用米非司酮联合香棱丸加味对复发率及血清性激素的影响[J].现代中西医结合杂志,2016,25(23):2556-2558.
[17]张莉.桂枝茯苓丸联合米非司酮治疗子宫肌瘤的疗效及对激素水平和血液流变学的影响[J].现代中西医结合杂志,2016,25(2):172-174.
[18]Aluwee S A,Kato H,Zhou X,et al.Magnetic resonance imaging of uterine fibroids:a preliminary investigation into the usefulness of 3D-rendered images for surgical planning[J].Springerplus,2015,4(1):384.
[19]江飞云,倪观太.逍遥丸联合米非司酮治疗肝郁血虚脾弱型子宫肌瘤的临床疗效[J].中国现代医学杂志,2016,26(24):97-100.
[20]方海娅,张海燕,寿华锋.米非司酮治疗围绝经期子宫肌瘤的临床研究[J].中国临床药理学杂志,2016,32(11):987-989.