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一项前瞻性干预性研究,旨在评估药物治疗(米非司酮25毫克)对子宫肌瘤治疗的效果。

A prospective interventional study to evaluate the effects of medical therapy (Mifepristone 25 mg) on the management of uterine fibroids.

作者信息

Gupta Meeta, Jamwal Narita, Sabharwal Sumeet, Sobti Shalini

机构信息

Department of Obstetrics and Gynecology, Acharaya Shri Chander College of Medical Sciences and Hospital (ASCOMS), Jammu, India.

Department of Radiodiagnosis, Superspeciality Hospital, GMC, Jammu, India.

出版信息

J Family Med Prim Care. 2020 Jul 30;9(7):3230-3235. doi: 10.4103/jfmpc.jfmpc_467_20. eCollection 2020 Jul.

Abstract

BACKGROUND AND OBJECTIVES

In India, the uterine fibroid is a common indication of hysterectomy. An effective option for medical treatment may decrease the morbidity associated with hysterectomy. We aimed to evaluate the effect of mifepristone (25 mg), progesterone antagonist, on uterine fibroids in perimenopausal women.

METHODS

Fifty-four perimenopausal women of age ≥18 years having symptomatic uterine fibroids were selected from Gynecology OPD and given 25 mg mifepristone once daily continuously for 2-4 cycles of 3 months each. Variables such as baseline fibroid size, position, and hemoglobin were measured and followed at 3, 6, 9, and 12 months. The data were entered in MS EXCEL spreadsheet and analysis was done using Statistical Package for Social Sciences (SPSS) version 21.0. A value of <0.05 was considered statistically significant.

RESULTS

Majority were intramural fibroids (70.37%) followed by submucosal in 16.67%. Size of fibroids ranged from <3 to >7 cm; the majority of fibroids were in 5-7 cm size. No significant association of location with the size of fibroid was found. Out of 54 cases included in the study, change in size in uterine fibroids was observed in 98.14% cases. There was an increase in hemoglobin, from 8.6 g% at baseline to 9.7 g% at 12 months.

CONCLUSION

Mifepristone resulted in a reduction in uterine fibroids size and an increase in hemoglobin at the end of 12 months. It may be an option for uterine leiomyoma treatment, as it is given orally, cost-effective and has minimal side effects.

摘要

背景与目的

在印度,子宫肌瘤是子宫切除术的常见指征。一种有效的药物治疗选择可能会降低与子宫切除术相关的发病率。我们旨在评估米非司酮(25毫克),一种孕激素拮抗剂,对围绝经期妇女子宫肌瘤的影响。

方法

从妇科门诊选取54名年龄≥18岁、有症状的子宫肌瘤围绝经期妇女,每天一次连续给予25毫克米非司酮,共2至4个周期,每个周期3个月。测量基线肌瘤大小、位置和血红蛋白等变量,并在3、6、9和12个月时进行随访。数据录入MS EXCEL电子表格,并使用社会科学统计软件包(SPSS)21.0版进行分析。P值<0.05被认为具有统计学意义。

结果

大多数为肌壁间肌瘤(70.37%),其次是黏膜下肌瘤,占16.67%。肌瘤大小从<3厘米到>7厘米不等;大多数肌瘤大小在5至7厘米之间。未发现肌瘤位置与大小之间存在显著关联。在纳入研究的54例病例中,98.14%的病例子宫肌瘤大小有变化。血红蛋白有所增加,从基线时的8.6克%增至12个月时的9.7克%。

结论

米非司酮在12个月末导致子宫肌瘤大小减小且血红蛋白增加。它可能是子宫肌瘤治疗的一种选择,因为它口服给药、成本效益高且副作用极小。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/09d7/7567249/6ae579b82189/JFMPC-9-3230-g001.jpg

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