绝经后应用激素替代治疗妇女的子宫内膜细胞形态观察  

Endometrial Cytology in Normal Postmenopausal Women and During Hormone Replacement Therapy

作　　者：魏杨[1,2] 薛加强[1,2] 林守清 徐小梅[1,2] 许仙玲 

机构地区：[1]北京铁路总医院妇产科 [2]中国医学科学院中国协和医科大学北京协和医院妇产科

出　　处：《中华妇产科杂志》1997年第7期432-435,I039,共5页Chinese Journal of Obstetrics and Gynecology

摘　　要：目的：观察绝经后应用激素替代治疗（ＨＲＴ）妇女子宫内膜细胞的形态改变；建立子宫内膜的监测方法。方法：应用塑料管负压法，吸取绝经后妇女６０例（非ＨＲＴ组）和应用ＨＲＴ３～１８个月妇女４１例（ＨＲＴ组）的子宫内膜细胞，进行细胞病理学诊断。结果：非ＨＲＴ组内膜细胞萎缩型为５１．７％，吞噬细胞为６８．３％；随着年龄增长及绝经时间的延长，萎缩型增加。ＨＲＴ组萎缩型和吞噬细胞分别为１２．２％和１７．０％，明显低于非ＨＲＴ组（Ｐ＜０．００５）。两组细胞类型均表现不均一（即同一涂片中可见到不同时期的细胞形态）。结论：绝经后子宫内膜细胞并非呈单纯萎缩型；应用ＨＲＴ后，子宫内膜细胞形态发生显著变化；采用塑料管负压吸取子宫内膜细胞进行检查，可用于子宫内膜的监测。Objective: To explore the possibility of endometrial cyopathologic examination as a method of monitoring endometrium during hormone replacement therapy (HRT) in postmenopausal women. Mehtods: Endometrial cells were taken via tubal aspiration in 60 normal postmenopausal women (non HRT group )and 41 with HRT for 3～18 months (HRT group). Their morphologic changes were observed and compared by cytopathologist. Results: Atrophic endometrium was found in 51.7% of the non HRT group. Its proportion increased with age and the time after menopause. Macrophages were seen in 68.3% of this group. However, in the HRT group the occurrence of atrophic type and macrophage (12.2%, 17 0% respectively) was significantly lower than that in the non HRT group ( P <0.05). Heterogeneity of endometrial cell type was shown both in non-HRT (38.3%) and HRT (65.8%) groups. Conclusions: Endometrial cells of postmenopausal women are not always atrophic in appearance. They change significantly during HRT. Endometrial cytological examination may be useful for monitoring during HRT.

关 键 词：绝经 子宫内膜 雌激素替代疗法 

分 类 号：R711.710.5[医药卫生—妇产科学]