Effect of Mifepristone in the adjuvant treatment of patients with perimenopausal dysfunctional uterine bleeding and its influence on serum nitric oxide, prostaglandin and endometrial thickness
SUN Hongxia ZHU Ting
Department of Gynecology, Suzhou Municipal Hospital Affiliated to Nanjing Medical University, Jiangsu Province, Suzhou 215002, China
Abstract：Objective To investigate the effect of Mifepristone in the adjuvant treatment of patients with perimenopausal dysfunctional uterine bleeding and its influence on serum nitric oxide (NO), prostaglandin and endometrial thickness. Methods One hundred and twenty cases of perimenopausal dysfunctional uterine bleeding patients in Suzhou Municipal Hospital Affiliated to Nanjing Medical University from August 2016 to July 2019 were selected as research objects. They were divided into combination group and control group by using random number table method, 60 cases in each group. Combination group was given Mifepristone and levonorgestrel intrauterine contraceptive system (LNG-IUS) treatment, control group was given LNG-IUS treatment. The course of treatment was 12 weeks. The endometrial thickness, serum NO, prostaglandin E2 (PGE2), prostaglandin 2α (PGF2α), peripheral blood hemoglobin (Hb) and vaginal bleeding time were compared between two groups before and after treatment. The adverse reactions of two groups were recorded. Results Twelve weeks of treatment, the endometrial thickness of two groups was thinner than that before treatment, and that of combination group was thinner than that of control group (P < 0.05). Twelve weeks of treatment, the level of Hb in combination group was higher than that in control group, and Hb level in control group was higher than that before treatment (P < 0.05). Twelve weeks of treatment, the serum NO level of two groups was lower than that before treatment, and that of combination group was lower than that of control group (P < 0.05). Twelve weeks of treatment, the serum levels of PGE2 and PGF2α in two groups were higher than those before treatment, and those in combination group were higher than those in control group (P < 0.05). Twelve weeks of treatment, the vaginal bleeding time of two groups was shorter than that before treatment, and that of combination group was shorter than that of control group (P < 0.05). There was no significant difference in the incidence of adverse reaction between two groups (P > 0.05). Conclusion Mifepristone combined with LNG-IUS is better than LNG-IUS in the treatment of perimenopausal dysfunctional uterine bleeding, and it has a better regulating effect on serum NO and PGF2α, and more effectively reduces the thickness of endometrium.
孙红霞 朱挺. 米非司酮辅助治疗围绝经期功能失调性子宫出血患者的效果及对血清NO、前列腺素、子宫内膜厚度的影响[J]. 中国医药导报, 2020, 17(35): 88-91.
SUN Hongxia ZHU Ting. Effect of Mifepristone in the adjuvant treatment of patients with perimenopausal dysfunctional uterine bleeding and its influence on serum nitric oxide, prostaglandin and endometrial thickness. 中国医药导报, 2020, 17(35): 88-91.
[1] 辛路平，蒋清清.不同方案治疗围绝经期功血的效果与安全性[J].中国性科学，2019，28（7）：106-109.
[2] 袁华.曼月乐联合妈富隆治疗围绝经期功血的临床疗效及对血清FSH、LH、E2、P水平的影响[J].标记免疫分析与临床，2018，25（11）：1666-1669.
[3] Nalgirkar SP，Vinchurkar SA，Saoji AA，et al. Yoga as a therapeutic intervention in the management of dysfunctional uterine bleeding：a controlled pilot study [J]. J Midlife Health，2018，9（1）：8-13.
[4] 兰瑞红，龚护民，杨扬.左炔诺孕酮宫内缓释系统治疗无排卵性功能失调性子宫出血的效果及对PDW、ET-1水平的影响[J].解放军预防医学杂志，2018，36（7）：886-889.
[5] 张海敏，张海琴.米非司酮预防功能失调性子宫出血子宫内膜息肉宫腔镜治疗后复发的效果研究[J].中国药物与临床，2019，19（20）：3580-3581.
[6] 袁学芝，郭金荣.米非司酮联合曼月乐对功血患者雌孕激素受体及子宫内膜bFGF、VEGF表达的影响[J].中华保健医学杂志，2019，21（1）：56-59.
[7] 谢幸，苟文丽.妇产科学[M].8版.北京：人民卫生出版社，2013：344-352.
[8] Motta T，Laganà AS，Valenti G，et al. Differential diagnosis and management of abnormal uterine bleeding in adolescence [J]. Minerva Ginecol，2017，69（6）：618-630.
[9] Sabbioni L，Zanetti I，Orlandini C，et al. Abnormal uterine bleeding unrelated to structural uterine abnormalities：management in the perimenopausal period [J]. Minerva Ginecol，2017，69（1）：75-83.
[10] Weaver K. Contraception in adolescence and the perimenopause [J]. Medicine，2017，29（9）：18-23.
[11] Nicula R，Diculescu D，Lencu CC，et al. Accuracy of transvaginal ultrasonography compared to endometrial biopsy for the etiological diagnosis of abnormal perimenopausal bleeding [J]. Clujul Med，2017，90（1）：33-39.
[12] Antovska VS，Trajanova M，Krstevska I，et al. Ovarian strumal carcinoid tumour：case report [J]. Open Access Maced J Med Sci，2018，6（3）：540-543.
[13] 李亚丽.系统评价米非司酮治疗围绝经期功能失调性子宫出血综合效果[J].山西医药杂志，2018，47（1）：46-49.
[14] Bar-On S，Ben-David A，Rattan G，et al. Is outpatient hysteroscopy accurate for the diagnosis of endometrial pathology among perimenopausal and postmenopausal women? [J]. Menopause，2018，25（2）：1.
[15] 曹爱娣，何耀娟，肖青，等.宫腔镜电切术联合米非司酮治疗围绝经期功能失调性子宫出血患者的疗效观察[J].医学临床研究，2018，35（8）：1586-1588.
[16] 杨威，王施元，徐超，等.青春期异常子宫出血合并贫血相关指标分析[J].哈尔滨医科大学学报，2018，52（5）：461-464.
[17] 陈群.宫腔镜子宫内膜射频消融术治疗妇女围绝经期功能失调性子宫出血的效果[J].中国医药科学，2019，9（8）：21-24.
[18] Cozza G，Pinto A，Giovanale V，et al. Comparative effectiveness and impact on health-related quality of life of hysterectomy vs. levonorgestrel intra-uterine system for abnormal uterine bleeding [J]. Eur Rev Med Pharmacol Sci，2017，21（9）：2255.
[19] 王楠，张坪，赵永玲，等.内皮型一氧化氮合酶表达及微血管密度评估体外受精患者子宫内膜容受性的价值[J].实用妇产科杂志，2017，33（3）：185-188.
[20] 申萌萌，刘雁峰.uNK/M-CSF/NO通路与子宫内膜容受性[J].中华中医药杂志，2017，32（4）：1650-1653.
[21] 欧莉，苗彦霞，高峰，等.二色补血草总黄酮治疗功能性子宫出血的止血作用及机制研究[J].吉林中医药，2019， 39（5）：638-641.
[22] 张正琼.促性腺激素释放激素激动剂联合腹腔镜手术治疗EMT疗效及对TRPV1、NGF、BK/BKB1R、PGF2α水平的影响[J].标记免疫分析与临床，2018，25（4）：509-512，555.
[23] Grzechocinska B，Dabrowski FA，Chlebus M，et al. Expression of matrix metalloproteinase enzymes in endometrium of women with abnormal uterine bleeding [J]. Neuro Endocrinol Lett，2018，38（8）：537.
[24] 王珏.LNG-IUS联合优思明治疗顽固性围绝经期功能失调性子宫出血临床疗效观察[J].贵州医药，2017，41（7）：754-755.
[25] 张碧黎，王依静，张雪芹.去氧孕烯炔雌醇片治疗围绝经期功能失调性子宫出血的临床研究[J].中国临床药理学杂志，2017，33（7）：599-601.
2020, Vol. 17 
京公网安备 11010502046598号