Efficacy of methotrexate combined with mifepristone in the treatment of ectopic pregnancy and its effect on serum human chorionic gonadotropin and cancer antigen 125 levels and endometrial thickness
10.3760/cma.j.issn.1008-6706.2021.03.021
- VernacularTitle:甲氨蝶呤联合米非司酮治疗异位妊娠疗效及对血清人绒毛膜促性腺激素、癌抗原125、子宫内膜厚度的影响
- Author:
Liying YING
;
Xuena CUI
;
Hongqiong DING
- From:
Chinese Journal of Primary Medicine and Pharmacy
2021;28(3):415-420
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the efficacy of methotrexate combined with mifepristone in the treatment of ectopic pregnancy and its effect on serum human chorionic gonadotropin (β-HCG) and cancer antigen 125 (CA125) levels and endometrial thickness.Methods:Eighty-two patients with ectopic pregnancy who received treatment in Ningbo Yinzhou No. 2 Hospital, China from August 2017 to August 2019 were included in this study. They were randomly assigned to receive treatment with methotrexate (control group, n = 41) or methotrexate combined with mifepristone (observation group, n = 41). Clinical efficacy was evaluated, and adverse reactions and clinical recovery indexes were observed in each group. Before and after treatment, serum biochemical indexes, endometrial thickness and mass diameter were compared between the observation and control groups. Results:Clinical efficacy in the observation group was significantly higher than that in the control group [95.12% (39/41) vs. 75.61% (31/41), χ2 = 6.248, P < 0.05]. The incidence of adverse reaction in the observation group was significantly lower than that in the control group [4.88% (2/41) vs. 19.51% (8/41), χ2 = 4.100, P < 0.05]. After treatment, serum β-HCG, CA125, progesterone and vascular endothelial growth factor levels in the control and observation groups were (1 106.26 ± 122.36) U/L and (902.65 ± 61.32) U/L, (32.26 ± 6.86) kU/L and (28.26 ± 5.26) kU/L, (15.33 ± 3.01) nmol/L and (10.33 ± 1.92) nmol/L, (85.36 ± 16.41) ng/L and (65.33 ± 12.22) ng/L, respectively, which were significantly lower than those before treatment ( t = 56.964 and 82.206, 12.380 and 17.642, 9.976 and 19.471, 7.490 and 12.912, all P < 0.05). After treatment, serum β-HCG, CA125, progesterone and vascular endothelial growth factor levels in the observation group were significantly lower than those in the control group ( t = 10.624, 3.304, 8.967, 6.991, all P < 0.05). After treatment, endometrial thickness and mass diameter in the control and observation groups were (8.23 ± 1.81) mm and (6.25 ± 1.25) mm, (2.21 ± 0.52) cm and (1.52 ± 0.35) cm respectively, which were significantly lower than those before treatment ( t = 3.555 and 15.118, 11.631 and 24.167, both P < 0.05). After treatment, endometrial thickness and mass diameter in the observation group were significantly less or smaller than those in the control group ( t = 6.248 and 7.861, both P < 0.05). After treatment, symptom disappearance time, serum β-HCG recovery time, urine β-HCG negative time, pelvic mass disappearance time and hospital stay in the control and observation groups were (7.26 ± 1.92) d and (4.23 ± 0.85) d, (16.25 ± 3.82) d and (12.33 ± 2.21) d, (15.36 ± 3.26) d and (10.66 ± 2.12) d, (24.12 ± 4.12) d and (18.66 ± 3.61) d, (29.58 ± 5.68) d and (23.52 ± 4.36) d, respectively. After treatment, symptom disappearance time, serum β-HCG recovery time, urine β-HCG negative time, pelvic mass disappearance time and hospital stay in the observation group were significantly shorter than those in the control group, respectively ( t = 10.305, 6.343, 8.631, 7.118, 6.044, all P < 0.05). Conclusion:Methotrexate combined with mifepristone is highly effective in the treatment of ectopic pregnancy because it can reduce adverse reactions, decrease serum β-HCG, CA125, progesterone and vascular endothelial growth factor levels, promote the recovery of serum β-HCG to normal level, reduce endometrial thickness, and promote adnexal mass disappearance, which are conducive to the early recovery of patients, with good clinical safety.
