论文部分内容阅读
药物流产是一种非手术流产,使用方便、安全无痛、可接受性强.近20年来,国内外在探索有效地终止早孕药物方面已有显著进展,口服药物流产仍是终止早孕的更为先进的新方法.目前主要采用口服米非司酮配伍米索前列醇终止早孕.现简述如下:1 药理作用及临床特点1.1 米非司酮(Mifepristone简称Ru486)Ru486是法国Roussel-Uclaf公司80年代初首先合成并成功地用于临床.是作用于受体的新型抗孕酮的甾体药物,用于终止早孕已在20多个国家应用.Ru486无孕激素、雌激素、雄激素和抗雄激素活性,含有抗孕酮和抗肾上腺激素的成份,对孕酮受体的亲和力比黄体酮强5倍.它主要作用于下丘脑和(或)垂体,抑制卵泡刺激素、黄体生成素及卵巢激素的分泌.在靶细胞上竞争性地抑制可取代体内孕酮,与孕酮受体结合,抑制孕酮活性,导致体内绒毛膜促性腺激素水平急剧下降,继之黄体溶解,从而引起子宫蜕膜和绒毛变性,内源性前列腺素(PG)释放,进一步促进宫缩和软化,扩张宫颈,最终引起孕产物的排出.所以Ru486具有诱发月经,抑制排卵,抗着床,终止妊娠、死胎引产和避孕作用.
Medical abortion is a non-surgical abortion, easy to use, safe and painless, acceptable.For nearly 20 years, at home and abroad to explore the effective termination of early pregnancy drugs have made significant progress, oral abortion is still termination of early pregnancy more Advanced new method.At present, the main use of oral mifepristone with misoprostol to terminate early pregnancy are as follows: 1 pharmacological effects and clinical features 1.1 mifepristone (Ru486) Ru486 is the French company Roussel-Uclaf 80 First synthesized in early age and successfully used in clinical. Is a new type of anti-progesterone steroid drugs acting on the receptor, used to terminate early pregnancy in more than 20 countries .Ru486 no progesterone, estrogen, androgen and anti-anti Androgenic activity, containing antiprogestins and anti-adrenal hormones, has a 5-fold stronger affinity for progesterone receptors than progesterone and acts mainly on the hypothalamus and / or pituitary to inhibit follicle stimulating hormone, luteinizing hormone and Ovarian hormone secretion.Competitive inhibition of target cells in the body can replace progesterone, and progesterone receptor binding, inhibition of progesterone activity, leading to a sharp drop in the level of human chorionic gonadotropin, followed by luteal lysis, from Cause decidua and villus degeneration, endogenous prostaglandin (PG) release, to further promote uterine contractions and softening, expansion of the cervix, eventually causing the discharge of pregnant women, so Ru486 has induced menstruation, inhibition of ovulation, anti-implantation, termination of pregnancy , Stillbirth induction and contraception.