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米非司酮(mifepristone,RU486)是国际上第一个上市的用于终止妊娠的药物,不仅已被临床用于终止早期和中期妊娠,而且在终止中晚期妊娠方面也有潜在的临床应用前景。通过综述有关文献得出,作为孕激素受体和糖皮质激素受体拮抗剂,米非司酮影响母-胎界面局部的免疫细胞分化和功能,蜕膜和绒毛细胞外基质重构,母-胎界面各种细胞凋亡等生理过程,诱发母-胎界面免疫耐受状态失衡,作为导致妊娠终止的主要机制。另外,米非司酮还通过影响子宫颈结缔组织分解和子宫平滑肌收缩等方式阻止妊娠。借助动物模型和临床数据,全面解析米非司酮的作用机制是未来研究的趋势。
Mifepristone (RU486) is the first drug in the world to be used for termination of pregnancy. It has been clinically used to terminate early and midterm pregnancies and has potential clinical application in terminating late pregnancy. By reviewing the literature, mifepristone, as a progesterone receptor and a glucocorticoid receptor antagonist, influences local immune cell differentiation and function at the maternal-fetal interface, extracellular matrix remodeling of decidua and villus, Fetal cell interface apoptosis and other physiological processes, induced immune imbalance at the mother-child interface, as the main mechanism leading to the termination of pregnancy. In addition, mifepristone also prevents pregnancy by affecting cervical connective tissue breakdown and uterine smooth muscle contraction. With animal models and clinical data, a comprehensive analysis of the mechanism of action of mifepristone is the trend of future research.