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米非司酮和醋酸亮丙瑞林对子宫肌瘤子宫动脉血流的影响:一项前瞻性随机研究。

The effects of RU 486 and leuprolide acetate on uterine artery blood flow in the fibroid uterus: a prospective, randomized study.

作者信息

Reinsch R C, Murphy A A, Morales A J, Yen S S

机构信息

Department of Obstetrics and Gynecology, Kaiser Permanente, University of California, San Diego 92103.

出版信息

Am J Obstet Gynecol. 1994 Jun;170(6):1623-7; discussion 1627-8.

PMID:8203418
Abstract

OBJECTIVE

Our purpose was to examine the effects of RU 486 and leuprolide acetate on uterine artery blood flow and uterine volume.

STUDY DESIGN

Patients were randomly assigned to group A (eight patients) receiving 25 mg of RU 486 daily for 3 months or group B (six patients) receiving 3.75 mg of leuprolide acetate monthly for 3 months. Uterine artery blood flow change was determined by resistive index by means of vaginal color Doppler ultrasonography. Uterine volume was measured before and during the study with abdominal ultrasonography.

RESULTS

Both groups showed an increase in resistive index. Patients receiving RU 486 had uterine artery blood flow decreased by 40%, and those receiving leuprolide acetate had a 21% decrease. We noted a significant decrease in uterine volume compared with pretreatment in both groups at 3 months. There was no significant decrease between groups.

CONCLUSION

Both RU 486 (25 mg daily) and leuprolide acetate (3.75 mg monthly) are effective in decreasing blood flow to the uterus (increasing resistive index) and decreasing uterine volume at 3 months. A significant decrease in uterine artery blood flow may provide a mechanism for the decrease in uterine size and the decrease in uterine blood loss at the time of surgery.

摘要

目的

我们的目的是研究米非司酮和醋酸亮丙瑞林对子宫动脉血流及子宫体积的影响。

研究设计

患者被随机分为A组(8例患者),每天服用25毫克米非司酮,共3个月;或B组(6例患者),每月注射3.75毫克醋酸亮丙瑞林,共3个月。采用经阴道彩色多普勒超声通过阻力指数测定子宫动脉血流变化。在研究前及研究期间用腹部超声测量子宫体积。

结果

两组的阻力指数均升高。服用米非司酮的患者子宫动脉血流减少40%,服用醋酸亮丙瑞林的患者减少21%。我们注意到两组在3个月时子宫体积与治疗前相比均显著减小。两组之间无显著差异。

结论

米非司酮(每日25毫克)和醋酸亮丙瑞林(每月3.75毫克)在3个月时均能有效减少子宫血流(增加阻力指数)并减小子宫体积。子宫动脉血流的显著减少可能为手术时子宫大小减小及子宫失血量减少提供一种机制。

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