单剂量甲氨蝶呤对异位妊娠的全身治疗。

Systemic treatment of ectopic pregnancies with single-dose methotrexate.

作者信息

Schäfer D, Kryss J, Pfuhl J, Baumann R

机构信息

Department of Obstetrics and Gynaecology, University of Frankfurt am Main, Theodor-Stern-Kai 7, D-60590 Frankfurt/Main, Germany.

出版信息

J Am Assoc Gynecol Laparosc. 1994 May;1(3):213-8. doi: 10.1016/s1074-3804(05)81012-6.

DOI:10.1016/s1074-3804(05)81012-6

PMID:9050489

Abstract

STUDY OBJECTIVE

To evaluate the success rate, side effects, reproductive outcome, and possible pitfalls of systemic low-dose methotrexate (MTX) for treatment of ectopic pregnancy (EP).

DESIGN

Longitudinal, nonrandomized trial Setting. Department of Obstetrics and Gynaecology at a teaching hospital in Germany.

PATIENTS AND INTERVENTIONS

Forty women with EP were treated with a single dose of MTX 20 to 40 mg intravenously. The highest pretreatment human chorionic gonadotropin (hCG) titer was 21,100 mIU/ml.

MEASUREMENTS AND MAIN RESULTS

Thirty-seven patients (92.5%) were treated successfully. Thirty-four (85%) received a single dose of MTX. Six (15%) required a second dose about a week later. Three patients (7. 5%) required surgical intervention. Serum MTX levels decreased below 0.1 micromol/L (45.4 microg/L) within 24 hours. In 53.8% of women hCG levels decreased directly after treatment; in 46.2% levels increased within the first 5 days after treatment.

CONCLUSIONS

In selected patients, systemic low-dose MTX is an effective way to treat EP, and has no demonstrable side effects.

摘要

研究目的

评估全身低剂量甲氨蝶呤（MTX）治疗异位妊娠（EP）的成功率、副作用、生殖结局及可能存在的问题。

设计

纵向、非随机试验。地点：德国一家教学医院的妇产科。

患者与干预措施

40例异位妊娠患者静脉注射单剂量MTX 20至40毫克。治疗前最高人绒毛膜促性腺激素（hCG）滴度为21,100 mIU/ml。

测量指标与主要结果

37例患者（92.5%）治疗成功。34例（85%）接受单剂量MTX治疗。6例（15%）约一周后需接受第二剂治疗。3例患者（7.5%）需要手术干预。血清MTX水平在24小时内降至0.1微摩尔/升（45.4微克/升）以下。53.8%的女性治疗后hCG水平直接下降；46.2%的女性治疗后前5天内hCG水平升高。