子宫内膜异位症孕酮抵抗机制研究进展  

Research Progress of the Progesterone Resistance Mechanisms of Endometriosis

作　　者：施秀[1] 徐炜[1] 戴辉华[1] 王秀丽[1] 

机构地区：[1]南京医科大学第一附属医院妇科,南京210029

出　　处：《国际妇产科学杂志》2013年第6期548-550,570,共4页Journal of International Obstetrics and Gynecology

基　　金：国家自然科学基金(81070471);江苏省"十二五"兴卫工程重点人才课题(RC20061)

摘　　要：子宫内膜异位症(EMs)中异位内膜周期性出血形成的病灶导致女性严重的盆腔疼痛与不孕。EMs是一种雌二醇(E2)依赖性疾病,孕酮是拮抗E2的经典药物。EMs患者血清孕酮水平正常,但子宫内膜对孕酮的反应性却明显下降,导致着床期子宫内膜容受性下降,不孕症发生率增加。在临床治疗中,多数EMs患者对孕酮治疗呈现低反应或无反应,这些都称为EMs的孕酮抵抗现象。孕酮抵抗机制涉及孕酮受体(PR)的缺陷,PR辅激活子的改变,基因和环境因素的变化以及雌激素受体亚型的改变等。综述有关EMs孕酮抵抗的相关机制,为克服EMs孕酮抵抗提供理论基础。Endometriosis （EMs） is defined by the presence of visible endometrial implants outside the uterus,mostly occurred in the pelvic organs. The cyclical bleeding of eetopic endometrial lesions leads to serious pelvic pain and infertility of women. EMs is widely viewed as an estrogen-dependent disorder. Progesterone is the classic drug to antagonist estrogen. But in the clinical practice ,the majority of the endometriosis patients show low reaction or non-reaction on progestin therapy. Attenuation of progesterone response at the level of the endometrium may be expected to have a deleterious impact on endometrial receptivity and fertility. These phenomena are called progesterone resistance of EMs. The progesterone resistance mechanism involves the defect of the progesterone reeeptor（PR）, the change of progesterone receptor co-regulators and the genetic and environmental factors as well as ERα/ERβ. The aim of this review is to highlight recent findings regarding the progesterone resistance mechanisms and to provide theoretical basis for overcoming progesterone resistance.

关 键 词：子宫内膜异位症 孕酮 受体 孕酮 受体 雌激素 

分 类 号：R711.71[医药卫生—妇产科学]