李苹　吕育纯

[摘要] 目的 评析比较子宫肌瘤应用亮丙瑞林与米非司酮治疗的临床效果。方法 依据随机对照的研究方式将整群选取的该院于2013年3月—2015年3月收治的74例子宫肌瘤患者划分为对照、实验两组，例数均为37例，两组分别采用亮丙瑞林与米非司酮治疗，疗程为3个月，尔后以B超测定两组治疗前后子宫、子宫肌瘤的三维径线并计算出体积进行比较，测定患者血清激素水平，并观察用药不良反应。结果 实验组治疗前的子宫体积、子宫肌瘤体积分别为（322.2±33.6） m3、（87.4±9.2） cm3，与对照组的（323.1±32.9） cm3、（88.1±10.0） cm3相比差异无统计学意义（P>0.05），治疗后实验组的子宫体积、子宫肌瘤体积分别为（233.4±27.6） cm3、（50.2±7.1） cm3与对照组的（236.1±26.2） cm3、（50.9±7.4） cm3相比还是差异无统计学意义（P>0.05）；实验组治疗前E2、FSH、LH、P等血清激素水平分别为（277.7±33.3） pmol/L、（9.1±2.2） U/L、（9.6±2.1） U/L、（7.8±1.5） nmol/L，与对照组的（279.8±35.4） pmol/L、（9.3±2.1） U/L、（9.7±2.2） U/L、（7.9±1.4） nmol/L相比差异无统计学意义（P>0.05），实验组治疗后各项激素水平分别为（165.2±33.5） pmol/L、（6.5±1.2） U/L、（6.6±1.2） U/L、（4.0±0.7） nmol/L相较于治疗前均有明显改善（P<0.05），与对照组的（181.8±30.9） pmol/L、（8.3±1.2） U/L（8.1±1.1） U/L、（5.5±1.5） nmol/L均差异有统计学意义（P<0.05），提示实验组改善更为显著。两组治疗期间均未见严重不良反应。结论 子宫肌瘤应用米非司酮治疗可有效缩小子宫肌瘤体积，降低雌、孕激素水平，且不良反应轻微，综合疗效确切，具显著临床推广价值。

[关键词] 子宫肌瘤；亮丙瑞林；米非司酮

[中图分类号] R737.33 [文献标识码] A [文章编号] 1674-0742（2015）12（c）-0007-03

Comparison the Clinical Effect Between Leuprolide and Mifepristone in the Treatment of Uterine Fibroids

LI Ping， LV Yu-chun

Quanzhou First Hospital Affiliated to Fujian Medical University， Quanzhou， Fujian Province， 362000 China

[Abstract] Objective To evaluate and compare the clinical effect between Leuprolide and Mifepristone in the treatment of uterine fibroids. Methods A randomized controlled study was used in this study. 74 cases with uterine fibroids admitted in our hospital from March 2013 to March 2015 were divided into the control group and the experimental group with 37 cases in each. The control group were treated by Leuprolide， and the experimental group were treated by Mifepristone， for 3 months. The three-dimensional diameter of the uterus and uterine fibroids were measured in both groups by the B-mode ultrasonography before and after treatment. The volume of the uterus and uterine fibroids of the two groups were calculated and compared. The serum hormone level was measured and the incidence of adverse reactions was observed in both groups. Results Before treatment， there was no statistically significant difference between the experimental group and the control group in the volume of uterus （322.2±33.6） cm3 vs （323.1±32.9） cm3 and the volume of uterine fibroids （87.4±9.2） cm3 vs （88.1±10.0） cm3 （P>0.05）. After treatment， there was still no statistically significant difference between the experimental group and the control group in the volume of uterus （233.4±27.6） cm3 vs （236.1±26.2） cm3 and the volume of uterine fibroids （50.2±7.1） cm3 vs （50.9±7.4） cm3 （P>0.05）. Before treatment， there was no statistically significant difference between the experimental group and the control group in the level of E2 （277.7±33.3） pmol/L vs （279.8±35.4） pmol/L， FSH level （9.1±2.2） U/L vs （9.3±2.1） U/L， LH level （9.6±2.1） U/L vs （9.7±2.2） U/L， P level （7.8±1.5） nmol/L vs （7.9±1.4） nmol/L （P>0.05）. After treatment， the level of E2， FSH， LH and P was respectively （165.2±33.5） pmol/L， （6.5±1.2） U/L， （6.6±1.2） U/L， （4.0±0.7） nmol/L in the experimental group， compared with that before treatment， the level of E2， FSH， LH and P improved significantly （P<0.05）. The level of E2， FSH， LH and P was respectively （181.8±30.9） pmol/L， （8.3±1.2） U/L， （8.1±1.1） U/L， and （5.5±1.5） nmol/L in the control group after treatment， which showed that the improvement in the experimental group was much better than that in the control group， the difference in E2， FSH， LH and P levels between the experimental group and the control group after treatment was statistically significant （P<0.05）. No serious adverse events occurred in both groups during treatment. Conclusion Mifepristone can effectively reduce the volume of uterine fibroids， lower the estrogen and progesterone levels with mild adverse reactions， exact comprehensive effect and a significant clinical value of promotion.

[Key words] Uterine fibroids； Leuprolide； Mifepristone

子宫肌瘤系女性生殖系统中最为常见的良性肿瘤，其又被称为子宫平滑肌瘤，患病率高达25%。子宫肌瘤并无特异临床表现，甚至有很大部分患者无明显症状，但若不进行有效干预，瘤体体积会不断增大，甚至发生恶变[1-2]。研究发现，子宫肌瘤本质上是性激素依赖性肿瘤，其发生发展与患者体内雌孕激素紊乱密切相关，故合理应用激素类药物可影响体内性激素水平，进而干扰肌瘤生长[3]。米非司酮与亮丙瑞林是现阶段用于子宫肌瘤治疗的主要药物，该院整群选取2013年3月—2015年3月该院收治的74例子宫肌瘤患者参与调查，采用米非司酮与亮丙瑞林治疗，获满意成效，现报道如下。