McCord M L, Muram D, Lipscomb G H, Powell M P, Arheart K L
Department of Obstetrics and Gynecology, University of Tennessee, Memphis 38103, USA.
J Pediatr Adolesc Gynecol. 1996 Apr;9(2):71-3. doi: 10.1016/s1083-3188(96)70013-x.
To determine the suitability and efficacy of methotrexate (MTX) therapy for adolescent patients with ectopic pregnancy.
Patients with ectopic pregnancy were treated with methotrexate, 50 mg/m2 intramuscularly. Follow-up determinations of quantitative beta hCG levels were done on days 1, 4, and 7. They were then seen weekly until beta hCG levels were less than 15 mIU/ml.
Adolescents with ectopic pregnancy (55 patients) received MTX therapy and comprised the study group. They were compared with 186 adults similarly treated. The groups were compared for treatment outcome and for compliance with the rigid protocol requirements.
Treatment success was defined as a patient who required no surgical intervention and whose beta hCG levels declined to < 15 mIU/ml.
85% of patients required no surgical intervention following MTX injection. Surgical intervention rates were slightly higher and success rates slightly lower for adolescent patients, but these differences were not statistically significant (p = .71). Although adult patients were more likely to have a perfect compliance rating, comparison of all compliance categories showed no significant differences (p = .17).
MTX therapy is satisfactory for adolescent patients. It is effective, and adolescent patients are able to comply with the requirements of a rigid protocol.
确定甲氨蝶呤（MTX）治疗青春期异位妊娠患者的适用性和疗效。
异位妊娠患者接受甲氨蝶呤治疗，剂量为50mg/m²，肌肉注射。在第1、4和7天对β-hCG定量水平进行随访测定。然后每周对患者进行检查，直至β-hCG水平低于15mIU/ml。
患有异位妊娠的青少年（55例患者）接受MTX治疗，组成研究组。将他们与186例接受相同治疗的成年人进行比较。比较两组的治疗结果以及对严格方案要求的依从性。
治疗成功定义为无需手术干预且β-hCG水平降至<15mIU/ml的患者。
85%的患者在注射MTX后无需手术干预。青少年患者的手术干预率略高，成功率略低，但这些差异无统计学意义（p = 0.71）。尽管成年患者更有可能获得完美的依从性评分，但所有依从性类别的比较均无显著差异（p = 0.17）。
MTX治疗对青春期患者是令人满意的。它是有效的，并且青春期患者能够遵守严格方案的要求。
