黄体酮临床应用现状及研究进展

Current status and study advances of clinical application of progesterone

黄体酮是一种由胎盘、卵巢和肾上腺合成的类固醇激素,对生殖功能和调节月经周期至关重要比如排卵和怀孕的开始和维持,对女性的子宫内膜有着显著保护作用。激素作用主要归因于特征明确的经典信号通路。孕酮的作用主要通过经典信号通路通过配体结合到核孕酮受体。目前,临床常用的适应证有先兆流产、预防早产、功能失调性子宫出血、黄体功能不全等。在子宫内膜异位症中,当子宫内膜组织生长在宫腔外时,黄体酮和雌激素信号被破坏,通常导致黄体酮抵抗和雌激素占主导地位。黄体酮临床安全性主要由给药途径决定,给药方式主要有口服给药、肌内注射、阴道给药等方式。本文就黄体酮临床应用以及临床药理学、临床安全性做一综述,为临床合理用药提供参考。

Progesterone is a steroid hormone secreted by the placenta,ovary and adrenal gland,which is essential for reproductive function and regulation of the menstrual cycle such as the onset and maintenance of ovulation and pregnancy,and has a significant protective effect on the female endometrium.The hormonal effects are mainly attributed to well-characterized classical signaling pathways.The progesterone binds to the nuclear progesterone receptor mainly through the classical signaling pathway via ligand.Currently,the common clinical indications of progesterone are early threatened abortion,prevention of preterm birth,dysfunctional uterine bleeding,and luteal function insufficiency.In endometriosis,progesterone and estrogen signaling is disrupted since endometrial tissue grows outside the uterine cavity,usually resulting in progesterone resistance and estrogen dominance.The clinical safety of progesterone is mainly determined by the route of administration,which mainly includes oral administration,intramuscular injection,and vaginal administration.This paper intends to review the clinical application,clinical pharmacology and clinical safety of progesterone,aiming to provide a reference for the rational medication.