定量分析雌孕激素对改善子宫内膜状态的作用

The effect of estrogen, progesterone on the en- dometrial development by the quantitative analysis.

126例子宫内膜分泌不良的不孕妇女分别使用雌、孕激素类药物治疗(A组60例),单纯孕激素治疗(B组66例),用流式细胞仪定量观察用药前后子宫内膜雌激素受体(ER)、孕激素受体(PR)含量及组织学变化。结果表明,A组用药后ER、PR含量明显增加(P<0.05、P<0.01),且组织学变化接近正常月经周期内膜或与其同步。而B组用药前后ER、PR含量及组织学观察无明显变化(P>0.05,P>0.05),部分病例的ER、PR含量有下降趋势。提示对ER、PR含量低下的子宫内膜发育不良者,合理使用雌、孕激素类药物治疗,可提高靶细胞的受体含量、使内膜发育得到改善,是不孕症治疗的环节之一。

Objective: To provide a basis for the rational use of estrogens and progesterones in infertile women. Method: 126 infertile women with inadequate secretory endometrinm were randomly divided into two groups. Group A was treated with Clomiphene Citrate (CC ), estrogen (diethylstilbestrol ) and progesterone ( Medroxyprogesterone Acetate ) Group B was treated with progesterone (Medroxyprogesterone Acetate) alone. Before and after treatment the estrogen receptor (ER) and proes-terone receptor (PR) of the endometrium were quantified by flow cytometry, and the histology of endometri - um was analyzed. Results: Treatment with estrogen and progesterone increased the ER, PR content of the endometrial cells. In Group A, the ER, PR content (mean±SD) before treatment was 31. 66 ±1. 42, 32. 00 ±1. 80, and after treatment was 42. 42±1. 53, 44. 80±1. 52 (P<0. 05, P <0. 01) respeerivety. In Group B, the comparable value before treatment was 31. 86±1. 66, 32. 00± 1. 66, and after treatment was 28. 88±1. 33, 30. 88 ±1. 42 (P>0. 05, P>0. 05) respectively. Histo-logical dating the endometrium in Gruoup A approached that of the normal cyclic day, while such changes were not seen in Group B. Conclusion: Rational use of estrogen and progesterone is important for the treatment of the women with infertility. Infertile women with low ER, PR contents in the endometrium responded positively to the combine treatment of CC with diethylstilbesterol followed by medroxyprogesterone acetate. Not only the ER, PR contents of the endometrial cells were increased , but also the endometrial development , im- proved. Detection of ER, PR contents by flow cy-gometry has been found to be accurate and convenient.