目的:观察长疗程服用米非司酮治疗子宫肌瘤的效果及对糖皮质激素的影响。方法:60例子宫肌瘤患者,从月经1~2天开始,每日口服米非司酮5 mg,连续服6个月。分别于治疗前、治疗3个月和治疗6个月测量子宫及肌瘤的三维径线,用免疫化学发光法测定血清皮质醇(C)、雌二醇(E2)、孕酮(P)、促黄体生成素(LH)、促卵泡素(FSH),并检查肝肾功能和血红蛋白,记录患者的不良反应。结果:用药6个月肌瘤体积缩小了59.2%,与服药3个月相比,差异有统计学意义(P<0.01)。治疗3个月,35%的(14/40)患者出现抗糖皮质激素症状,治疗6个月症状无明显加重。有抗糖皮质激素症状患者血清皮质醇治疗3个月时明显升高(23%),而治疗6个月时明显降低(26.8%),P<0.05,与无抗糖皮质激素症状患者相比较,差异有统计学意义,P<0.05。结论:口服米非司酮5mg 6个月,部分患者出现轻度抗糖皮质激素效应伴随血清皮质醇的波动;测定血清皮质醇水平可能不适合用来判断有无米非司酮抗糖皮质激素效应发生;长疗程用药后子宫肌瘤明显缩小。 OBJECTIVE: To observe the effect of taking mifepristone on long-term course of treatment of uterine fibroids and its effect on glucocorticoids. Methods: 60 patients with uterine fibroids, menstruation from 1 to 2 days, daily oral mifepristone 5 mg, continuous service for 6 months. The three-dimensional diameter of the uterus and fibroids were measured before treatment, 3 months after treatment and 6 months after treatment, respectively. Serum cortisol, estradiol and progesterone were measured by immunochemiluminescence. Luteinizing hormone (LH), follicle stimulating hormone (FSH), and check the liver and kidney function and hemoglobin, record the patient’s adverse reactions. Results: The volume of fibroids decreased by 59.2% at 6 months, which was significantly different from that of 3 months (P <0.01). Treatment for 3 months, 35% (14/40) of patients with anti-glucocorticoid symptoms, symptoms of six months of treatment no significant increase. Serum cortisol in patients with anti-glucocorticoid symptoms was significantly elevated at 3 months (23%) and significantly lower at 6 months (26.8%), P <0.05 compared with patients without anti-glucocorticoid treatment , The difference was statistically significant, P <0.05. Conclusion: Mifepristone 5mg 6 months, some patients with mild anti-glucocorticoid effect with fluctuations in serum cortisol; Determination of serum cortisol levels may not be suitable for judging the presence or absence of mifepristone anti-glucocorticoid Effect; long course of treatment of uterine fibroids significantly reduced.