米非司酮治療糖尿病婦女圍絕經期功能失調性子宮出血療效觀察

金廣艷

[摘要] 目的 探討米非司酮治療糖尿病婦女圍絕經期功能失調性子宮出血的效果。方法 選取2017年1月—2018年1月該科收治的圍絕經期功血的糖尿病婦女28例，隨機分為兩組各14例，觀察組給予米非司酮，對照組給予醋酸甲羥孕酮，比較效果。結果 觀察組總有效率為92.9%，明顯優于對照組71.4%（P<0.05）；治療后觀察組E2、LH、P、子宮內膜厚度顯著低于對照組（P<0.05）。結論 米非司酮治療糖尿病婦女圍絕經期功血效果顯著，值得應用。

[關鍵詞] 米非司酮；糖尿病；圍絕經期功血

[中圖分類號] R587.1 [文獻標識碼] A [文章編號] 1672-4062（2018）07（a）-0083-02

Observation on Curative Effect of Mifepristone in Treatment of Perimenopausal Dysfunctional Uterine Bleeding of Diabetes Women

JIN Guang-yan

Department of Gynecology and Obstetrics， Central Hospital of Changchun economic and Technological Development Zone， Changchun， Jilin Province， 130000 China

[Abstract] Objective To study the curative effect of mifepristone in treatment of perimenopausal dysfunctional uterine bleeding of diabetes women. Methods 28 cases of diabetes women with perimenopausal dysfunctional uterine bleeding admitted and treated in our hospital from January 2017 to January 2018 were selected and randomly divided into two groups with 14 cases in each， the observation group and the control group were respectively treated with mifepristone and medroxyprogesterone acetate， and the effect was compared between the two groups. Results The total effective rate in the observation group was obviously better than that in the control group （92.9% vs 71.4%）（P<0.05）； after treatment， the E2， LH， P， endometrium thickness in the observation group were obviously lower than those in the control group（P<0.05）. Conclusion The effect of mifepristone in treatment of Perimenopausal dysfunctional uterine bleeding of diabetes women is obvious， which is worth application.

[Key words] Mifepristone； Diabetes； Perimenopausal dysfunctional uterine bleeding

圍絕經期功能失調性子宮出血（圍絕經期功血）是婦科常見的病癥[1]，嚴重影響婦女的身心健康。糖尿病是一組以高血糖為特征的代謝性疾病。近年來，糖尿病對女性的生長發育、月經、生殖功能有著顯著的影響，尤其糖尿病婦女發生圍絕經期功血時，體內孕激素水平降低，組織細胞對胰島素敏感性增強[2]，再加上這一時期女性情緒波動較大，容易引起血糖增高且難以控制，如不及時治療，可引發嚴重的貧血和并發癥。該科對2017年1月—2018年1月收治的14例圍絕經期功血的糖尿病婦女采用米非司酮治療，探討米非司酮治療糖尿病婦女圍絕經期功血的療效，現報道如下。

1 資料與方法

1.1 一般資料

選取該科收治的圍絕經期功血的糖尿病婦女28例為觀察對象，隨機分為兩組各14例，觀察組年齡44～55歲，平均（49.2±2.1）歲，糖尿病病程平均（5.7±1.3）年，功血病程平均（7.5±1.2）個月，伴貧血6例；對照組年齡43～55歲，平均（50.1±2.4）歲，糖尿病病程平均（5.4±1.1）年，功血病程平均（7.1±0.6）個月，伴貧血5例。均經診斷性刮宮證實為單純性子宮內膜增生，排除子宮肌瘤、子宮內膜異位癥、內膜癌及嚴重肝腎功能異常者。婦女均知情同意并經倫理委員會批準。兩組患者一般資料比較差異無統計學意義（P>0.05）。

1.2 治療方法

患者均控制血糖，給予口服降糖藥或胰島素。觀察組：給予米非司酮片（25 mg/片，國藥準字H10950202）12.5 mg /d，清晨空腹頓服，連服3個月。對照組：給予醋酸甲羥孕酮片（2 mg/片，國藥準字H33020715）8 mg/d，連服21 d停藥，出現撤退性出血后第5天開始服用，連服3周期。

1.3 觀察內容