CAJ | 학술논문

目的：探讨米索前列醇的序贯使用对早孕患者血清凋亡因子及远期疗效的影响研究。方法选取辽宁中医药大学附属第四医院计划生育门诊就诊要求终止妊娠的早孕妇女80例，随机数字表达法分为2组，对照组40例，口服米非司酮25 mg后，予以常规米索前列醇600μg，1天4次口服；实验组40例，米索前列醇行序贯给药方式。观察用药7 d后药流效果，检测患者药流前后血清中survivin、caspase－3及性激素水平变化。随访2年，统计用药后妇科炎症、痛经、不孕等副反应的发生率。结果与对照组比较，实验组完全流产率较高（P＜0．05）；经2年随访，实验组患者药流后药物副反应发生率低于对照组（P＜0．05）；服药7 d后，与对照组比较，实验组人绒毛膜促性腺激素、孕酮及雌三醇的含量较低（P＜0．05）；服药7 d后，血清survivin水平降低，caspase－3水平升高，与对照组相比，实验组患者血清中survivin水平较低，caspase－3水平较高（P＜0．05）。结论米索前列醇的序贯使用能够提高药流人流的成功率，降低人流术的并发症，可能其与抑制survivin表达，上调caspase－3水平有关。
목적：탐토미색전렬순적서관사용대조잉환자혈청조망인자급원기료효적영향연구。방법선취료녕중의약대학부속제사의원계화생육문진취진요구종지임신적조잉부녀80례，수궤수자표체법분위2조，대조조40례，구복미비사동25 mg후，여이상규미색전렬순600μg，1천4차구복；실험조40례，미색전렬순행서관급약방식。관찰용약7 d후약류효과，검측환자약류전후혈청중survivin、caspase－3급성격소수평변화。수방2년，통계용약후부과염증、통경、불잉등부반응적발생솔。결과여대조조비교，실험조완전유산솔교고（P＜0．05）；경2년수방，실험조환자약류후약물부반응발생솔저우대조조（P＜0．05）；복약7 d후，여대조조비교，실험조인융모막촉성선격소、잉동급자삼순적함량교저（P＜0．05）；복약7 d후，혈청survivin수평강저，caspase－3수평승고，여대조조상비，실험조환자혈청중survivin수평교저，caspase－3수평교고（P＜0．05）。결론미색전렬순적서관사용능구제고약류인류적성공솔，강저인류술적병발증，가능기여억제survivin표체，상조caspase－3수평유관。
Objective To investigate effect of serum apoptosis factor and long-term effect on medical abortion patients by sequential misoprostol. Methods 80 cases of early pregnancy patients who required termination pregnancy, were selected and randomly divided into 2 groups.40 cases in control group were treated with mifepristone 25mg oral, misoprostol 600μg, 4 times a day.40 cases in experiment group were treated with sequential use of misoprostol.Effect of medical abortion, survivin and caspase-3 were compared after 7d treatment.Gynecological inflammation, dysmenorrhea and infertility were compared for 2 years.Results Compared with control group, complete abortion rate of the experiment group was higher (P<0.05).The incidence of adverse drug reactions of the experiment group was lower than control group (P<0.05) after 2 years follow.up.Compared with the control group, HCG,E3 and P of experimental group were lower (P<0.05).After 7 days of medication,survivin decreased,caspase-3 increased,compared with control group, survivin of the experiment group was lower, caspase-3 was higher ( P<0.05 ) .Conclusion Misoprostol sequential can improve the success rate of medical abortion abortion, reduce the complications of abortion, presumably with the inhibition of survivin expression, is associated up regulation of caspase-3 levels.