米非司酮治疗糖尿病妇女围绝经期功能失调性子宫出血疗效观察

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[摘要] 目的 探讨米非司酮治疗糖尿病妇女围绝经期功能失调性子宫出血的效果。方法 选取2017年1月—2018年1月该科收治的围绝经期功血的糖尿病妇女28例，随机分为两组各14例，观察组给予米非司酮，对照组给予醋酸甲羟孕酮，比较效果。结果 观察组总有效率为92.9%，明显优于对照组71.4%（P<0.05）；治疗后观察组E2、LH、P、子宫内膜厚度显著低于对照组（P<0.05）。结论 米非司酮治疗糖尿病妇女围绝经期功血效果显著，值得应用。

[关键词] 米非司酮；糖尿病；围绝经期功血

[中图分类号] R587.1 [文献标识码] A [文章编号] 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

圍绝经期功能失调性子宫出血（围绝经期功血）是妇科常见的病症[1]，严重影响妇女的身心健康。糖尿病是一组以高血糖为特征的代谢性疾病。近年来，糖尿病对女性的生长发育、月经、生殖功能有着显著的影响，尤其糖尿病妇女发生围绝经期功血时，体内孕激素水平降低，组织细胞对胰岛素敏感性增强[2]，再加上这一时期女性情绪波动较大，容易引起血糖增高且难以控制，如不及时治疗，可引发严重的贫血和并发症。该科对2017年1月—2018年1月收治的14例围绝经期功血的糖尿病妇女采用米非司酮治疗，探讨米非司酮治疗糖尿病妇女围绝经期功血的疗效，现报道如下。

1 资料与方法

1.1 一般资料

选取该科收治的围绝经期功血的糖尿病妇女28例为观察对象，随机分为两组各14例，观察组年龄44～55岁，平均（49.2±2.1）岁，糖尿病病程平均（5.7±1.3）年，功血病程平均（7.5±1.2）个月，伴贫血6例；对照组年龄43～55岁，平均（50.1±2.4）岁，糖尿病病程平均（5.4±1.1）年，功血病程平均（7.1±0.6）个月，伴贫血5例。均经诊断性刮宫证实为单纯性子宫内膜增生，排除子宫肌瘤、子宫内膜异位症、内膜癌及严重肝肾功能异常者。妇女均知情同意并经伦理委员会批准。两组患者一般资料比较差异无统计学意义（P>0.05）。

1.2 治疗方法

患者均控制血糖，给予口服降糖药或胰岛素。观察组：给予米非司酮片（25 mg/片，国药准字H10950202）12.5 mg /d，清晨空腹顿服，连服3个月。对照组：给予醋酸甲羟孕酮片（2 mg/片，国药准字H33020715）8 mg/d，连服21 d停药，出现撤退性出血后第5天开始服用，连服3周期。

1.3 观察内容