目的 · 探讨米非司酮在体外对人输卵管上皮纤毛摆动（CBF）及雌、孕激素受体表达的影响。方法 · 将 25 例人输卵管上皮组 织在体外经米非司酮（0.1、1、10 μmol/L）、孕酮 10 μmol/L、米非司酮（0.1、1、10 μmol/L）+ 孕酮 10 μmol/L 分别培养 24 h 后（另 设空白对照组），测得 CBF 值；应用实时荧光定量 PCR 和免疫组织化学技术分析经米非司酮处理后人输卵管上雌激素受体 α（ERα） 和孕激素受体（PR）的变化；透射电子显微镜观察 10 μmol/L 米非司酮对人输卵管上皮超微结构的影响。结果 · 与空白对照组相比， 米非司酮在0.1、1、10 μmol/L 浓度时对输卵管CBF 无显著影响（P=0.728，P=0.405，P=0.941）；孕酮 10 μmol/L 组 CBF 明显下降 （P=0.000），米非司酮在 0.1、1、10 μmol/L 浓度时，呈剂量－反应拮抗孕酮下调 CBF 的效应（P=0.484，P=0.000，P=0.000）。经米非 司酮培养 24 h 后，输卵管上的 ERα、PR 表达上调；输卵管上皮纤毛超微结构与空白对照组比较，无明显差异。结论 · 米非司酮在人 输卵管上发挥孕酮拮抗效应，这可能是这类常用口服紧急避孕药的输卵管避孕机制。
Objective · To investigate ciliary beat frequency (CBF), and estrogen and progesterone receptor expression levels of human fallopian tubes after mifepristone treating in vitro. Methods · Human fallopian tube mucosa explants (n=25) were treated with different concentrations of mifepristone (0.1, 1 and 10 μmol/L) or progesterone (10 μmol/L) separately, or both mifepristone and progesterone. After 24 h of treatment, CBF was measured. Quantitative real-time PCR and immunohistochemistry were used to research the expression of estrogen receptor-α (ERα) and progesterone receptor (PR) of human fallopian tubes after mifepristone treating. The ultrastructure of epithelial cells of fallopian tube after mifepristone (10 μmol/L) treating were observed with transmission electron microscopy. Results · The CBF at the concentrations of 0.1, 1 and 10 μmol/L was not affected by mifepristone (P=0.728, P=0.405 and P=0.941). The CBF decreased markedly in the group of 10 μmol/L progesterone compared to control group (P=0.000). Mifepristone (0.1, 1 and 10 μmol/L) dose dependently antagonized the progesterone-induced CBF decrease (P=0.484, P=0.000 and P=0.000). Mifepristone upregulated the expression levels of ERα and PR in the fallopian tubes, but the ultrastructure of the cilia had no significant change. Conclusion · Mifepristone acts as progesterone antagonist in the human fallopian tube, which may explain the tubal contraceptive mechanism when used as an emergency contraceptive.
