目的　探讨米非司酮对子宫肌瘤与子宫腺肌病的作用机制及临床治疗效果。方法　选择门诊病人 ,子宫肌瘤病人 5 0例 ,全部为壁间肌瘤 ,其直径为 3～ 7cm ,子宫腺肌病 10例。按年龄段分成四组 ,月经干净后第 3天开始口服米非司酮 2 5mg ,日服 1次 ,连续服用 3个月 ,观察肌瘤大小的变化。此外 ,采用多点法测定子宫肌瘤、子宫腺肌病及正常子宫肌层组织中孕激素受体含量。结果　子宫肌瘤体积于用药第 4周开始下降 ,平均下降了 19% (19%± 3 6 % ) ,第 8周平均下降了 39 3% (39 3 %± 5 4% ) ,至 12周明显下降 ,平均下降了 48 6 % (48 6 %± 8 7% ) ,统计学处理 ,差异有显著意义 (P <0 0 0 1)。从个别病例上观察仅有 3例无变化 ,而 4例体积下降 72 %。各组间差异无显著意义。子宫腺肌病病人子宫体积平均减少了 17 6 % ,统计学处理差异有显著意义 (P <0 0 5 ) ,临床症状减轻或消失。服药 3个月后追踪 2 0例病人 (18例子宫肌瘤 ,2例子宫腺肌病 ) ,子宫彩超检查显示 ,子宫与子宫肌瘤体积无增大趋势。子宫肌瘤与子宫腺肌病病人子宫肌层组织内的孕激素受体含量高于正常的子宫肌层组织。结论　子宫肌瘤组织与子宫腺肌病病人子宫肌层组织孕激素受体表达高于正常子宫肌层组织 ,米非司酮阻断孕激素作用 ,使子宫肌瘤体 Objective To investigate the mechanism of mifepristone on uterine leiomyoma and adenomyosis and its therapeutic effect. Methods Fifty outpatients and uterine fibroids were selected, all of them were intramural fibroids, with diameter of 3 ~ 7cm and adenomyosis of 10 cases. According to age group divided into four groups, the first three days after menstruation was started oral mifepristone 25mg, 1 day, taking 3 consecutive months to observe changes in fibroids size. In addition, multi-point determination of uterine fibroids, adenomyosis and normal uterine myometrium progesterone receptor content. Results Uterine fibroids began to decline in the fourth week of treatment, with an average decrease of 19% (19% ± 36%), an average decrease of 393% (39 3% ± 54%) in the eighth week and a significant decrease to the 12th week Decreased by an average of 48 6% (48 6% ± 8 7%). Statistical analysis showed significant difference (P 0 01). In only a few cases, only 3 cases showed no change, while 4 cases showed a 72% decrease in volume. No significant difference between the groups. Uterine adenomyosis patient’s uterus volume reduced by an average of 17.6%, the statistical difference was significant (P <0 05), clinical symptoms reduced or disappeared. 3 months after taking the medication 20 patients (18 cases of uterine fibroids, 2 cases of adenomyosis), uterine ultrasound examination showed no increase in the volume of uterine and uterine fibroids trend. Uterine fibroids and adenomyosis patients with uterine myometrial progesterone receptor content higher than normal myometrial tissue. Conclusion The expression of progesterone receptor in uterine muscle tissue of patients with uterine fibroids and adenomyosis is higher than that in normal myometrium. Mifepristone blocks the effect of progesterone,