第35卷第5期2007年10月广州医学院学报ACADEMICJOURNALOFGUANGZHOUMEDICALCOLLEGEV01．35No．5Oct．2007比较米非司酮和炔诺酮治疗围绝经期无排卵性功能性子宫出血郑峥1罗辉兰1谢梅青2‘李海刚3(1深圳市妇幼保健院妇产科，广东深圳518028；2中山大学附属第二医院妇产科，广东广州510120；3中山大学附属第二医院病理科，广东广州510120)·临床研究·摘要目的：探讨小剂量米非司酮和炔诺酮治疗围绝经期无排卵性功能性子宫出血的临床疗效。方法：收集本院妇产科门诊围绝经期无排卵性功能性子宫出血患者86例，随机分为两组。米非司酮(6．25me／d)组43例，连续服用90d；炔诺酮(5．0mg／d)组43例，连续服用20d，撤血后第5天开始第2个周期，连用3个周期。用药前后进行子宫内膜组织病理学检查，测定性激素6项、子宫内膜厚度、血红蛋白含量及肝肾功能。结果：两组治疗前均为单纯型增生的子宫内膜，治疗后转化为增生期内膜，与治疗前相比差异有统计学意义(P<0．05)。米非司酮组治疗后孕酮(P)和雌二醇(E2)显著下降(P<0．05)。两组治疗后子宫内膜厚度均较治疗前变薄(P<0．05)。两组治疗后血红蛋白含量较治疗前明显增加(P<0．05)，米非司酮组治疗后血红蛋白含量升高较炔诺酮组显著(P<0．05)。结论：米非司酮治疗囤绝经期无排卵性功能性子宫出血，与炔诺酮相似都能抑制子宫内膜单纯型增生过长；米非司酮可迅速改善月经过多和继发贫血的临床症状，药物不良反应小。关键词围绝经期；无排卵性功能性子宫出血；米非司酮／治疗；炔诺酮／治疗中图分类号R711．52文献标识码：A文章编号：1008—1836(2007)05—0038一04TreatmentOutcomesofLow．doseMifepristone(RU486)andNorethindrone(NID)inAnovulatoryFunctionalUterineBleedinginPremenopausalWomenZHENGZhen91，LUOHui—lanl，XIEMei·qin92，LIHal-gan93(1DepartmentofGynecology&Obstetrics，ShenzhenMaternity&ChildHealthInstitute，Shenzhen518028；2DepartmentofGynecology&Obstetrics，SecondAffiliatedHospitalofSunYat—senUniversity。Guangzhou510182；’DepartmentofPathology，SecondAffiliatedHospitalofSunYat一8errUniversity，Guangzhou510182，China)Abstract0bjective：Toevaluatethetreatmentoutcomesoflow-dosemifepfistone(RU486)andnorethindrone(NID)inanovulatoryfunctionalbleedinginpremenopausalwomen．Methods：Eishty—sixpremenopausalwomenwithanovulatoryfunctionaluterinebleedingwererandomizedintotwogroupstoreceiveRU486orNID．TheRU486Group(n=43)weretreatedwith6．25mg／dRU486consecutivelyfor90days，whereasintheNIDgroup(n=43)，5．0mg／dNIDwaftadministeredfor20daysasacycle，andWasrepeatedonday5ofwithdrawalbleedinguntilcompletionof3cycles．Beforeandafterthetreatment，dataonendometrialhistopathology，aserumpanelof6眈xhormones，endometrialthickness，contentsofhemoglobin．andthefunctionsofliverandkidneywereassessed．Results：Thebothgroupspresentedwithsimpleendometricalhyperplasiabeforetreatments，whichWassignificantlyswitchedtoproliferativestageaftermedication(P<0．05)．SerumlevelsofPandE2weredecreasedwithRU486(P<0．05)．柚ert弛atments．patientsinbothgroupswerefoundwithreducedendometrialthicknessandelevatedlevelofhemoglobin(bothP<0．05)．ThereWasagreaterincreaseinhemoglobinintheRU486GroupcomparedwiththeNIDgroup(P<0．05)．Conclusion：AnovulatoryfunctionaluterinebleedinginpremenopausalwomenCanbetreatedwithlow．dosemifepristoneornorethindrone．Thebothmayprovideinhibitiononover—growthofsimplehyperplastieendometrium．Inaddition，low-dosemifepristoneWasshowntorapidlyrelievemenorrhagiaandsecondaryanemia，andWaSalsowell．tolerated．Keywordspremenopausalperiod；anovulatoryfunctionalbleeding；mifepristone(RU486)／treatment；norethindrone(NID)／treatment基金项目：广东省卫生厅自然基金资助项目(项目编号A20...
