口服避孕药妇女子宫颈上皮巨幼样变及应用叶酸治疗的研究  

Megaloblastic Changes in Cervical Epithelium Associated with Oral Contraceptives and Changes after Treatment with Folic Acid

作　　者：李小峰[1] 冉家彦[1] 饶惠玲[1] 王来远[1] 晋淑媛[1] 

机构地区：[1]山西医学院第二附属医院内科,山西医学院第二附属医院妇产科

出　　处：《中华妇产科杂志》1995年第7期410-413,共4页Chinese Journal of Obstetrics and Gynecology

摘　　要：对１０１例口服避孕药妇女（服药组）和３３例放置宫内节育器正常妇女（对照组）的宫颈刮片进行宫颈上皮细胞形态学变化的观察，同时测定血清及红细胞内的叶酸含量。结果：服药组平均宫颈上皮细胞核直径显著大于对照组（Ｐ＜０．００１）．服药组２９例（２８．７％）出现宫颈上皮巨幼样变，对照组出现２例（６．５％），两者比较，差异有显著性（Ｐ＜０．０１）。两组的血清叶酸含量、血红蛋白和中性分叶核指数相比较，无差别。服药组红细胞内叶酸含量低于对照组，差异有显著性（Ｐ＜０．０５）。对服药组的２６例宫颈上皮巨幼样变妇女给予叶酸治疗３～４周后，平均细胞核直径较治疗前明显缩小（Ｐ＜０．００１），多核和空泡现象消失。提示：口服避孕药可导致宫颈上皮细胞巨幼样变，用叶酸可以起到治疗作用。bjective To study the influence of oral contraceptives on cervical epithelium,serum and red blood cell folate levels of users and to observe the changes after treatment with folic acid. Metbods Morphology of cervical epithelium,serum folate and red blood r cell folate levels were stud- ied in 101 women who had used oral contraceptives for over 6 months and 33 intrauterine devices users served as controls,29 women using oral contraceptives with cervical megaloblastic changes were treated with folic acid(5mg daily)for 3～4weeks and followed up for observation on morphological changes of cervical epithelium. Results The mean nuclear diameter of cervical epithelial cells was larger in the oral contraceptive group than that in the control group(P<0.001).Megaloblastic changes in cervical epithelium occured in 29 women in the oral contraceptive group(28.7%).There was significant difference in the occur-rence of cervical megaloblastic changes between the two groups(P<0.01).The level of red blood cell folate was lower in the oral contraceptive group than that in the control group(P<0.05).There was no difference in serum folate,hemoglobin and neutrophil nuclear index between the two groups(P >0.05).The mean nuclear diameter of cervical epthelial cells decreased signiflcantly (P<0.001)and multinuclear and vacuolar changes disappeared after folic acid therapy in 26 women with megaloblastic changes. Conclusions Oral contraceptives reduced folate storage in the the body and resulted in megaloblastic changes in cervical epithelium,This condition was improved with folic acid therapy.

关 键 词：避孕药 口服 叶酸 子宫颈 上皮巨幼样变 

分 类 号：R169.41[医药卫生—公共卫生与预防医学] R977.22