异位妊娠时子宫内膜的形态变化

Morphologic Changes of Endometrium in Patients with Ectopic Pregnancy

目的：探讨异位妊娠时子宫内膜形态变化的规律。方法：回顾分析我院２１７例异位妊娠子宫内膜的形态变化。结果：异位妊娠时子宫内膜变化有７种类型：（１）蜕膜和Ａｒｉａｓ－Ｓｔｅｌａ反应（Ａ－Ｓ反应）；（２）高度分泌反应；（３）分泌反应不同步；（４）部分呈分泌反应、部分呈增生反应，并出现一种“小Ａ－Ｓ”腺体；（５）早、中、晚分泌期；（６）增生反应；（７）腺囊型增生过长。异位妊娠时内膜形态与有无阴道流血、流血时间长短及尿ｈＣＧ水平有关。结论：不能以是否出现蜕膜和Ａ－Ｓ反应做为诊断异位妊娠的依据，须结合病史和实验室检查才能准确判断。

Objectives: To study the morphologic changes of endometrium in patients of ectopic pregnancy. Methods: The pathologic appearence of endometrium obtained during uterine curettage in 217 cases of ectopic pregnancy in our hospital were analysed retrospectively. Results: Seven types of endometrial changes were observed: (1) decidua and/or Arias Stella (A S) reaction 147 cases (67.74%), (2) hypersecretory changes 13 cases (5.99%), (3) asynchronous secretory changes between the glands and the stroma 27 cases (12.44%), (4) partial secretory and partial proliferative changes in glands 18 cases (8.29%), a type of small A S gland was found in 11 of them, (5) early, mid, or late secretory changes 9 cases (4.15%), (6) proliferative changes 2 cases (0.92%) and (7) glandular cystic hyperplasia 1 case (0.46%). The above morphologic changes of endometrium were correlated with the occurrence and duration of vaginal bleeding and the urinary hCG levels. Conclusion: The appearence of decidua and A S reaction should not be considered the only diagnostic basis for ectopic pregnancy. Patient's history and laboratory findings should also be taken into account in order to acquire an accurate diagnosis.