全子宫切除术后雌激素及孕激素的变化与子宫内膜相应受体的关系

Relationship between the changes of plasma estrogen and progestogen and the related receptors of endometrium after uterectomy

目的:探讨全子宫切除术后雌、孕激素水平的变化与子宫内膜组织中相应受体的量化关系。方法:选择我院因子宫肌瘤行全子宫切除术的未绝经病人70例(观察组),根据术后标本中测得子宫内膜组织雌激素受体含量分为3组,A组,雌激素受体平均含量>80%;B组,50%～80%;C组,<50%。所有病人分别于术前经净7d内及术后6个月同一日早晨空腹抽血测卵泡刺激素(FSH)、黄体生成激素(LH)、雌二醇(E2)、孕酮(P),另同时选择体检人群中健康妇女30例作为对照组。结果:观察组患者术前所测FSH、LH、P与对照组相比差异无显著性,E2明显升高,差异有显著性。术后半年A、B、C3组分别与术前比较FSH、LH(C组除外)均明显升高,E2明显降低,差异有显著性(P<0.05),P无明显变化;术后组间比较,A组FSH、LH明显高于C组,E2明显低于C组,差异有显著性;B、C组术后FSH均上升但两组间差异无显著性,LH均上升,但B组上升较C组明显,差异有显著性,E2均下降,但两组间差异无显著性。结论:全子宫切除术后半年卵巢功能明显衰退,且子宫内膜组织中雌激素受体含量高的A组较受体含量低的B、C两组卵巢功能改变更明显,证实了子宫内膜受体在生殖内分泌系统中起重要的调节作用。

Objective To evaluate the quantitative relationship between the changes of plasma estrogen and pregestogen and the related receptors of endometrium after the uterectomy. Methods Seventy patients whose uterus were excised were chosen in our hospital because of hysteremyoma, and derided into 3 groups according to the contents of estrogen receptor（ER） of endometrium after the operation, ER 〉 80% as group A, ER 50% - 80% as Group B and ER 〈 50% as Group C. The blood samples of all the patients were collected within 7 days after the menstruation before operation and the same day of 6 months after operation in the empty stomach to exam the contents of FSH, LH, E2 and P in the body. Another 30 healthy women were chosen as control group. Results Campared with control group, the levels of FSH, LH and P of 70 patients before operation showed no difference, but the level of E2 rose significantly in the group A, B and C. After half a year of opetration, the levels of FSH and LH（except for group C） significantly increased, while the level of E2 significantly decreased（ P 〈 0. 05）, and the level of P has no obvious change as compared with prior to the operation. After the operation, the levels of FSH and LH in group A and group B were higher than that in group C, and the level of E2 was lower than that in group C. Conclusions Ovary function has obviously declined after half a year of the uterectomy, the higher content of ER in the tissue of endometrium, the more obvious the declination of ovary function. It is shown that the receptors of endometrium play an important role in the endocrine system of reproduction.