长期使用超低剂量米非司酮控制子宫肌瘤及安全性探讨：一例报告。
Long-term use of ultra-low-dose mifepristone for uterine leiomyoma control and safety discussion: A case report.
机构信息
MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Obstetrics and Gynecology, Shanghai Changhai Hospital, China.
出版信息
Medicine (Baltimore). 2022 Dec 30;101(52):e32413. doi: 10.1097/MD.0000000000032413.
RATIONALE
In recent years, many clinical trials have used low-dose mifepristone to control uterine fibroids, some of which have achieved good results. However, according to the classic concept, long-term use of mifepristone could induce malignant transformation of the endometrium, and the effect of ultra-low-dose of mifepristone on uterine fibroids is still uncertain. Researchers are short on cases of uterine fibroids treated with mifepristone for long periods (more than a year).
PATIENT CONCERNS
A 47-year-old woman went to the hospital because of anemia.
DIAGNOSES
The patient was diagnosed with uterine leiomyoma.
INTERVENTIONS
The patient refused the suggestion of surgery, she was continuously treated with an ultra-low-dose (12.5 mg per 5 days) of mifepristone monotherapy for 4 years.
OUTCOMES
The uterine leiomyoma was stable, anemia and other symptoms disappeared, and the menstrual cycle, liver and kidney function, and tumor markers were normal.
LESSONS
Judging from our case, long-term, ultra-low-dose mifepristone for uterine fibroids treatment was safe and more effective than conventional therapy.
背景
近年来，许多临床试验采用低剂量米非司酮治疗子宫肌瘤，部分取得了较好的效果。然而，根据经典概念，米非司酮长期使用可能会导致子宫内膜恶变，超低剂量米非司酮治疗子宫肌瘤的效果尚不确定。研究者们对接受米非司酮治疗超过 1 年（即长期）的子宫肌瘤病例数量较少。
患者关注
一位 47 岁女性因贫血就诊。
诊断
患者被诊断为子宫肌瘤。
干预措施
患者拒绝手术建议，她连续接受超低剂量（每 5 天 12.5 毫克）米非司酮单药治疗 4 年。
结果
子宫肌瘤稳定，贫血等症状消失，月经周期、肝肾功能和肿瘤标志物正常。
经验教训
从我们的病例来看，长期超低剂量米非司酮治疗子宫肌瘤安全且比常规治疗更有效。
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