黄体功能缺陷与子宫内膜效应不良患者的内分泌特征  

Endocrine Differences between Patients with Luteal Phase Deficiency and Inadequate Endometrial Response

作　　者：徐苗厚[1] 张振国[1] 江森[1] 许燕雪[1] 

机构地区：[1]山东医科大学附属医院妇产科

出　　处：《中华妇产科杂志》1997年第3期141-144,共4页Chinese Journal of Obstetrics and Gynecology

摘　　要：目的：分析比较黄体功能缺陷（ＬＰＤ）和子宫内膜效应不良（ＩＥＲ）患者的内分泌特征。方法：采用放射免疫法和放射性配体饱和竞争、葡聚糖活性碳吸附分析法，测定ＬＰＤ、ＩＥＲ患者和月经周期正常者（对照组）的血清激素水平及同一月经周期子宫内膜组织中的雌、孕激素受体含量。结果：ＬＰＤ患者黄体期的雌、孕激素水平显著低于对照组（Ｐ＜０．００１），其子宫内膜雌、孕激素受体含量在整个月经周期中与对照组无差异（Ｐ＞０．１）；而ＩＥＲ患者整个月经周期的血清雌激素水平均低于对照组（Ｐ＜０．００１），但黄体期的血清孕激素水平与对照组无差异（Ｐ＞０．１），子宫内膜增生期的胞浆雌激素受体、胞核孕激素受体和整个月经周期的胞浆孕激素受体含量亦显著低于对照组（Ｐ＜０．００１，Ｐ＜０．００１，Ｐ＜０．０５）。结论：ＬＰＤ和ＩＥＲ是内分泌特征根本不同的两种情况，ＬＰＤ主要表现为黄体细胞分泌雌、孕激素功能下降，子宫内膜相应受体含量正常；ＩＥＲ则为整个周期的雌激素水平降低及相应受体合成障碍，而黄体分泌孕激素的功能正常。Objective: To study the difference of endocrine characteristics between patients with luteal phase deficiency (LPD) and inadequate endometrial response (IER). Methods: Serum estradiol (E 2), progesterone (P), follicle stimulating hormone, luteinizing hormone and prolactin levels were determined by radioimmunoassay in cycles of LPD, IER and normal controls. Contents of endometrial cytoplasmic estradiol receptors (ERc), nuclear estradiol receptors (ERn), cytoplasmic progesterone receptors (PRc) and nuclear progesterone receptors (PRn) were determined by dextran coated charcoal assay in the same cycle. Results: Serum E 2 and P levels in the luteal phase of patients with LPD were significantly lower than those of normal group ( P <0.001), no significant difference of endometrial estrogen receptor and progesteron receptor contents was found between the two groups ( P >0.1). Serum E 2 le vels in both follicular and luteal phase of IER patients were significantly lower than those of normal groups ( P <0.001), but serum P levels in luteal phase of the two groups showed no difference ( P >0.1). The contents of ERc and PRn in proliferative phase and PRc contents throughout the menstrual cycle were also lower than those of the normal group ( P <0.001, <0.001 and <0.05 respectively). Conclusions: These results indicate that LPD and IER are two distinct entities in terms of endocrine characteristics. To distinguish underdeveloped endometrium caused by either LPD or IER is the key to choose appropriate treatment.

关 键 词：黄体退化 子宫内膜 雌激素 受体 孕酮 IER LPD 

分 类 号：R711.5[医药卫生—妇产科学]