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目的：对氨甲喋呤（ＭＴＸ）合并米非司酮与米索前列醇（米索）抗早孕的剂量、副作用作一初步探讨。方法：对２３２例孕囊直径＞１５ｍｍ的早孕妇女，其中１８２例在米非司酮配伍米索的基础上加用小剂量ＭＴＸ（３０ｍｇ、４５ｍｇ、６０ｍｇ），分次口服。对照组５０例为米非司酮配伍米索。结果：ＭＴＸ三个剂量组的完全流产率均达９５％以上，以６０ｍｇ组最高，但三组间差异无显著性（Ｐ＞０．０５），对照组完全流产率为８０％，与ＭＴＸ三组间均有显著性差异。药物流产后出血时间约为两周左右，各组间差异无显著性（Ｐ＞０．０５），服药两周后ＭＴＸ三组白细胞均在正常范围，绝对值有所下降，以６０ｍｇ组较明显（Ｐ＜０．０１）。结论：ＭＴＸ与米非司酮配伍米索抗早孕，可提高完全流产率和缩短出血时间，ＭＴＸ的剂量以３０ｍｇ为宜。
OBJECTIVE: To study the dose and side effects of methotrexate (MTX) combined with mifepristone and misoprostol (misoprostol) in early pregnancy. Methods: A total of 232 pregnant women with gestational sac diameter> 15 mm were enrolled in this study. 182 of them were given oral small doses of MTX (30mg, 45mg, 60mg) on the basis of mifepristone combined with misoprostol. Control group, 50 cases of mifepristone with misoprostol. Results: The complete abortion rate of the three dose groups of MTX reached more than 95%, highest in 60mg group, but there was no significant difference among the three groups (P> 0.05). The complete miscarriage rate in the control group was 80% There were significant differences between groups. Bleeding time after medical abortion was about two weeks, no significant difference between the groups (P> 0.05), two weeks after taking MTX three groups of leukocytes in the normal range, the absolute value decreased to 60mg group was more obvious (P <0.01). Conclusion: Combination of MTX and mifepristone with misoprostol can improve the rate of complete abortion and shorten the bleeding time. The dosage of MTX should be 30mg.