不同剂量雌激素对宫腔粘连分离术后卵巢功能及ESR1表达的影响

发布时间：2018-01-14 22:06

本文关键词：不同剂量雌激素对宫腔粘连分离术后卵巢功能及ESR1表达的影响　出处：《重庆医科大学学报》2017年04期 　论文类型：期刊论文

【摘要】：目的:探讨不同剂量雌激素对宫腔粘连(intrauterine adhesions,IUA)患者卵巢功能的抑制作用及对子宫内膜组织中雌激素受体1(estrogen receptor 1,ESR1)表达的影响。方法:选取我院宫腔镜诊治中心接受宫腔粘连分离手术患者56例,术后随机给予戊酸雌二醇(estradiol valerate,EV)4 mg/d(23例)、6 mg/d(17例)、9 mg/d(16例)周期治疗3个疗程。经黄体期孕酮检测随访治疗中、停药次月患者卵巢排卵情况。用Western blot和q PCR检测其中EV 4 mg组和EV 9 mg组患者术前、术后3个月内膜ESR1表达。结果:56例IUA患者激素治疗期间排卵抑制率为:EV 4 mg组8.69%,EV 6 mg组58.82%,EV 9 mg组93.75%(P0.05);停药次月排卵抑制率为EV 4 mg组4.34%,EV 6 mg组17.64%,EV 9 mg组56.25%(P0.05)。经分层分组分析治疗后轻中度IUA组、重度IUA组、EV 4 mg组、EV 9 mg组内膜ESR1表达与治疗前相比均明显下降(P0.05);仅重度IUA组中用EV9 mg治疗者ESR1表达下降幅度明显大于EV 4 mg者(P0.05)。结论:雌激素治疗剂量越大对卵巢排卵抑制作用越强,而大剂量雌激素对降低内膜ESR1表达似乎无明显优势。
[Abstract]:Objective: to investigate the effect of different doses of estrogen on intrauterine adhesions. Inhibition of ovarian function and estrogen receptor 1 estrogen receptor 1 in endometrium. Methods: 56 cases of hysteroscopy were selected from the center of hysteroscopic diagnosis and treatment for the separation of intrauterine adhesions. After operation, estradiol estradiol valerateate (4 mg/d(23) and estradiol valerate (6 mg/d(17) were given randomly after operation. 9 cases of mg/d(16) were treated with three courses of treatment. Progesterone was detected in luteal phase and followed up. Western blot and Q PCR were used to detect the ovulation of patients with EV4 mg and EV9 mg before operation. Results the inhibition rate of ovulation in 56 patients with IUA during hormone therapy was 8.69 EV 4 mg group and 8.69 EV 6 mg group 58.82% during hormone therapy. EV 9 mg group 93.75% P 0.05; The inhibition rate of ovulation in EV4 mg group was 17.64% in EV 4 mg group and EV 6 mg group in 6 mg group. After the treatment, the patients were divided into two groups: mild to moderate IUA group and severe IUA group (EV 4 mg). The expression of ESR1 in EV-9mg group was significantly lower than that before treatment. The decrease of ESR1 expression in patients with severe IUA treated with EV9 mg was significantly higher than that in patients with EV 4 mg (P0.05). Conclusion: the greater the dose of estrogen is, the stronger the inhibition of ovulation is. However, high dose estrogen had no obvious advantage in decreasing the expression of ESR1 in endometrium.
【作者单位】：重庆医科大学附属第一医院妇产科;
【基金】：国家自然科学基金资助项目(编号:81471417)
【分类号】：R713.4
【正文快照】： 宫腔粘连(intrauterine adhesion,IUA)是指各种原因尤其流产清宫术后[1]引起的子宫内膜基底层损伤,使宫腔部分或全部粘连或纤维化的一组疾病,表现为月经减少、闭经、反复流产、不孕及胎盘形成异常等。这一细胞外基质(extracellular matrix,ECM)进行性积聚和纤维化的病理性疾病

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