甲氨蝶呤治疗异位妊娠的疗效与副作用

[Efficacy and side effects of methotrexate in the treatment of ectopic pregnancy].

作者信息

Chen Ya-xia, Mao Yu-yan, Xie Xing

机构信息

Department of Gynecology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China.

出版信息

Zhonghua Fu Chan Ke Za Zhi. 2003 Dec;38(12):749-51.

PMID:14728847

Abstract

OBJECTIVE

To study the efficacy and side effects of methotrexate with different protocols in the treatment of ectopic pregnancy (EP).

METHODS

Total of 648 patients who had EP and were treated only with MTX were analysed. Patients were divided into six groups according to protocol: Group 1, 100 mg intravenously (IV); Group 2, 100 mg, IV, followed by citrovorum factor; Group 3, 20 mg, IV every day for five days; Group 4, 20 mg intramusculary (IM) every day for five days; Group 5, 75 mg, IV; Group 6, 75 mg, IM.

RESULTS

The rates of repeated MTX injection in group 1 - 6 because of inadequate decrease of hCG were 23.3%, 25.0%, 21.4%, 20.6%, 24.4% and 22.4% respectively. Success rates were 87.4%, 85.4%, 90.5%, 92.6%, 86.3% and 91.4% respectively. Rates of liver dysfunction were 10.3%, 8.3%, 64.3%, 69.1%, 8.7% and 31.0%.

CONCLUSION

Single-dose of 75 mg MTX IV injection may be the best regimen in the treatment of EP because of the same efficacy but the least side effects.

摘要

目的

研究不同方案的甲氨蝶呤治疗异位妊娠（EP）的疗效及副作用。

方法

分析648例仅接受甲氨蝶呤治疗的异位妊娠患者。根据方案将患者分为六组：第1组，静脉注射100mg；第2组，静脉注射100mg，随后给予亚叶酸钙；第3组，每天静脉注射20mg，共5天；第4组，每天肌肉注射20mg，共5天；第5组，静脉注射75mg；第6组，肌肉注射75mg。

结果

第1 - 6组因hCG下降不充分而重复注射甲氨蝶呤的比例分别为23.3%、25.0%、21.4%、20.6%、24.4%和22.4%。成功率分别为87.4%、85.4%、90.5%、92.6%、86.3%和91.4%。肝功能障碍发生率分别为10.3%、8.3%、64.3%、69.1%、8.7%和31.0%。