功能性子宫出血子宫内膜血管变化的研究

Changes of Endometrial Vessels in Dysfunctional Uterine Bleeding

目的 探讨内分泌功能紊乱和避孕药具引起的功能性子宫出血(DUB)病理变化的共同点。方法 应用组织学、免疫组织化学方法对DUB的子宫内膜进行组织形态学、血管内皮细胞CD34和基膜层粘连蛋白(LN)的比较研究。结果 避孕药具引发的出血为弥散性,内膜发育受抑制;而内分泌紊乱引发的出血为局灶性,内膜发育呈不同步状态。2组共同点是出血部位的血管呈断裂像,血管内皮细胞中CD34 和血管基膜中LN的阳性表达都明显减弱。结论 不同诱因的DUB导致子宫出血的直接因素均是毛细血管内皮细胞中CD34和基膜中LN的减少。

Objective To study the common changes in pathology of dysfunctional uterine bleeding(DUB) caused by endocrine disturbance and birth control medicine (Norplant). Methods Histology and immunohistochemistry were used to demonstrate the expression of CD34 in endothelial cell, laminin in basement membrane in endometrial vessels as well as morphometric analysis of the endometrium of DUB (contraceptive and endocrine disturbance). Results The bleeding caused by birth control medicine(Norplant)was diffuse and the growth of these endometrium was inhibited, while the bleeding caused by endocrine disturbance was localized and the growth of those endometrium appeared different state. The common ground of the two groups was that the blood vessels in bleeding position were not integrative and the expression of CD34 in endothelial cell and LN in basement membrane in blood vessel were distinctly weakened. Conclusion Whatever the inducement of DUB is, the direct changes of DUB is the decreasing of CD34 in endothelial cell and LN in basement membrane of capillary vessel.