长期使用Norplant皮下埋植剂对子宫内膜超微结构影响的研究  

Study on the endometrial ultrastructure changes of the long term use of Norplant implants in Chinese women

作　　者：张帝开[1] 余妙真[1] 郭璇华[1] 李海刚[1] 吴金浪[1] 杨冬梓[1] 邝健全[1] 

机构地区：[1]中山大学附属第二医院,广州510120

出　　处：《中国实用妇科与产科杂志》2005年第1期29-31,共3页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：广东省科技局攻关项目基金资助 (基金编码 962 2 0 44 2 )

摘　　要：目的　探讨Norplant皮下埋植剂长期使用对子宫内膜超微结构的影响。 方法　 1989年 10月至 2 0 0 2年 6月中山大学附属二院对 2 99例使用Norplant埋植剂达 5年以上的妇女 ,观察其子宫内膜的形态学 (光镜与电镜 )变化。结果　长期使用组月经表现较为正常 ,妊娠率为 0 33/10 0妇女年。宫腔镜直视下见子宫内膜变薄 ,77 0 8%子宫内膜覆盖良好 ;光镜下子宫内膜腺体数量减少 ,分布不均匀 ,部分呈萎缩型改变 ,间质蜕膜样改变 ,疏松 ,轻度水肿 ;电镜下腺上皮细胞呈低柱状 ,胞体变小 ,微绒毛脱落 ,稀疏 ,分泌颗粒减少 ,线粒体肿胀 ,外膜消失 ,基质变淡 ,甚至呈空泡状 ,粗面内质网扩张 ,此外 ,间质细胞出现细胞凋亡。结论　长期使用Norplant皮下埋植剂可抑制子宫内膜的发育 ,对子宫内膜是安全的。Objective To assess the effects of long term use of Norplant implants on the ultrastructure changes of endometrium.Methods From October 1989 to June 2002,two hundred and ninety nine women who had been exposed to Norplant for more than 5 years in the Second Affiliated Hospital of Sun Yat Sen university were assessed and changes of endometrial morphology were investigated.Results The women who received long term contraceptive implants manifested normal menstruation.During the observation period,the pregnancy rate was 0 33/100 women year.Thinned endometria was shown by hysteroscopy and 77 08% of them had a good cover of endometrium.The endometrial gland was reduced in number and unevenly distributed.Some glands were atrophic.A decidual change of stroma with mild edema was presented.Electronic microscopy showed that,the epithelial cells of the glands presented low columnar.The volume of the cell became smaller.Microvili was sloughed .The excretory granules decreased in number.The mitochondria became swollen and its external membrane disappeared.The matrix became less stained and even became in vavuole shape.The rough endoplasmic reticulum presented extension.In addition,stroma cells appeared apoptosis.Conclusion The subdermal contraceptive implant Norplant has a suppressive effect on endometrium and is safe to the endometrium.

关 键 词：子宫内膜 NORPLANT皮下埋植 超微结构 改变 电镜 光镜 妇女 间质 轻度 埋植剂 

分 类 号：R169.41[医药卫生—公共卫生与预防医学] R711