Abstract To explore the efficacy of mifepristone combined with methotrexate for treating patients with ectopic pregnancy(EP) of fallopian tubes, and to study its influence on the ovarian volume, number of antral follicles, and systolic hemodynamics of patients. Methods: 108 patients with EP of fallopian tubes were randomly selected and were divided into two groups(54 cases in each group) according to the random number table method. The patients in the control group were given methotrexate treatment, and the patients in the observation group were given mifepristone combined with methotrexate treatment. The clinical efficacy, the time of clinical symptoms improvement, and the ovarian function, such as the number of antral follicles, the rate of normal ovarian reserve function, and the peak systolic blood flow velocity(PSV) and end-diastolic blood flow velocity(EVD) of ovarian artery, the levels of serum biochemical indicators, such as serum carbohydrate antigen 125(CA125), progesterone(P), and vascular endothelial growth factor(VEGF), and the adverse reactions rate before treatment and in 2 months after treatment of the patients were compared between the two groups. Results: The total effective rate of the patients in the observation group(96.3%) was significantly higher than that(87.0%) of the patients in the control group. The time of vaginal bleeding, the time of abdominal pain disappearance, the time of urinary β-HCG turned to negative, the time of mass disappearance, and the time of menstrual recovery of the patients in the observation group were significantly shorter than those of the patients in the control group(all P<0.05). 2 months after treatment, the number of antral follicles of ovary(7.45±1.78 pieces) and the rate of normal ovarian reserve function(87.0%) of the patients in the observation group were significantly higher than those(6.21±1.53 pieces and 64,8%) of the patients in the control group. The values of PSV(15.13±2.52 cm/s) and EVD(6.23±1.55 cm/s) of the patients in the observation group were significantly lower than those(16.34±2.36 cm/s and 7.16±1.37 cm/s) of the patients in the control group. The serum levels of CA125(29.67±4.51 kU/L), P(11.37±3.12 mmol/L), and VEGF(66.72±7.43 ng/L) of the patients in the observation group were significantly lower than those(33.25±4.67 kU/L, 14.64±3.53 mmol/L, and 81.26±8.48 ng/L) of the patients in the control group(all P<0.05). The incidence of adverse reactions(11.1%) of the patients in the observation group had no significant different from that(16.7%) of the patients in the control group(P>0.05). Conclusion: Mifepristone combined with methotrexate for treating the patients with EP can significantly improve the therapeutic effect, speed up the improvement of symptoms and the recovery of ovarian function, without increasing the adverse reactions.
|