雌、孕激素及促性腺激素水平测定对于绝经后妇女子宫内膜异常病变筛查的临床研究

The clinical study of detecting the E_2 and P and stilmulating sex hormone's blood levels of postclimateric women with pathological changes of uteru's endometrium

目的探讨性激素水平测定对于筛查绝经后妇女子宫内膜病变的意义。方法选取我院门诊有充分手术指征的绝经后流血的患者,空腹时采肘静脉血3 ml采用放射免疫RIA法测定性激素水平,并行分段诊刮,任何程度的子宫内膜增殖或增生均视为异常子宫内膜。结果绝经后妇女子宫内膜异常病变患者的雌激素水平明显高于正常绝经妇女(P<0.05),尤其子宫内膜癌患者及子宫内膜不典型增生患者体内雌激素水平较正常绝经妇女显著增高,P<0.01,且前二者之间亦有明显差异(P<0.05)。结论绝经后妇女阴道流血不能作为子宫内膜异常病变筛查的单一指标,对绝经后妇女常规进行性激素检测可作为子宫内膜异常病变的筛查方法之一。

Objective To discuss the interests of detecting the hormone level to screening the pathological changes of endometriurn of postclimateric women. Methods Select bleeding postcilmacteric women with sufficient surgery indication of out-patients department of our hospital. Used RIA method to detect 3 ml venous blood sample at limosis of these women and did the segmentes diagnostic curettage. Any degree of proliferation or hyperplasia of uterus＇ endometrium was regarded as pathological change. Results The E2 blood levels of postclimateric women with pathological changes of uterus＇ endometrium were markedly higher than normal postclimateric women（ P 〈 0.05）, especially of carcinoma and atypical hyperplasia. Between the carcinoma and atypical hyperplasia of endometriurn women, there still had obvious difference（ P 〈 0.05）. Conclusion Bleeding can＇ t be the only direction to screen the endometriurn with pathological changes. Detecting the sex hormone level of postcfimateric women as an routine examine can be another screening method for investigting the pathological changes of endometrium.