摘要
Abstract
Objective To analyze the effects of adding low-dose mifepristone to dydrogesterone therapy on hemostatic outcomes,endometrium-related ultrasonographic indicators,and sex hormone levels in patients with perimenopausal ovulatory dysfunction abnormal uterine bleeding(AUB-O).Methods A total of 114 patients with perimenopausal AUB-O treated at Shangqiu First People's Hospital from May 2022 to February 2025 were retrospectively enrolled.According to the actual medication regimen,they were divided into a control group(58 cases,treated with dydrogesterone)and a study group(56 cases,treated with dydrogesterone plus low-dose mifepristone).Both groups were treated for three cycles.The graded therapeutic efficacy,time required to control bleeding and to achieve complete hemostasis,endometrial thickness and uterine volume measured by transvaginal ultrasonography,as well as changes in sex hormone levels and hemoglobin(Hb),were compared between the two groups.Adverse reactions were recorded,and recurrence within 6 months after drug withdrawal was followed up.Results The overall treatment response rate in the study group was higher than that in the control group,and the time to bleeding control and the time to complete hemostasis were both significantly shorter than those in the control group;the differences were statistically significant(P＜0.05).After treatment,the endometrial thickness in the study group was lower than that in the control group,with a statistically significant difference(P＜0.05).After treatment,follicle-stimulating hormone(FSH)and Hb levels in the study group were higher than those in the control group,whereas estradiol(E2)and progesterone(P)levels were lower than those in the control group;all differences were statistically significant(P＜0.05).During follow-up,the recurrence rate in the study group was lower than that in the control group,and the difference was statistically significant(P＜0.05).Conclusion On the basis of dydrogesterone therapy,the addition of low-dose mifepristone can improve the efficacy in treating perimenopausal AUB-O,shorten the time to hemostasis,improve endometrial status,and reduce the risk of recurrence after drug withdrawal,with good safety.关键词
异常子宫出血/围绝经期/地屈孕酮/米非司酮/性激素Key words
abnormal uterine bleeding/perimenopause/dydrogesterone/mifepristone/sex hormones
