Endometriosis and Mullerian Anomalies
Endometriosis and Mullerian Anomalies
复制标题
子宫内膜异位症和苗勒氏管异常
DOI：
--
复制
发表时间：
1987
影响因子：
7.2
通讯作者：
D. Henderson
中科院分区：
文献类型：
--
作者：
D. Olive;D. Henderson
虽然子宫内膜异位症的病因众多，但很明显，逆行月经和细胞介导的淋巴细胞毒性在疾病的发展中起着重要作用。子宫内膜异位症发病机制的综合理论认为，疾病的发展取决于逆行月经量和免疫反应清除碎片的能力。为了验证这一理论，我们对64名患有苗勒管异常和腹腔内手术的妇女进行了评估，以确定是否存在子宫内膜异位症、输卵管通畅、阴道积血或子宫积血以及流出道阻塞。结果显示，13例子宫内膜功能正常、输卵管通畅、流出道梗阻的妇女中有10例存在子宫内膜异位症，而43例无梗阻的妇女中只有16例存在子宫内膜异位症（77%对37%，P <0.01）。同样，9名有阴道积血或子宫积血的妇女中有8名患有子宫内膜异位症，而47名子宫内膜功能正常但无阴道积血/子宫积血的妇女中只有18名患有子宫内膜异位症（89比38%，P <0.01）。8例无子宫内膜的妇女均无子宫内膜异位症。这些数据支持逆行月经增加会增加子宫内膜异位症的可能性的概念。
Although numerous etiologies for endometriosis have been proposed, it is clear that retrograde menstruation and cellmediated lymphocytotoxicity each play a significant role in the disease's development. A comprehensive theory of pathogenesis of endometriosis holds that development of the disorder depends upon amount of retrograde menstruation and the ability of the immune response to remove the debris. To test this theory, 64 women with mullerian anomalies and intra-abdominal surgery were evaluated for the presence or absence of endometriosis, patency of tubes, hematocolpos or hematometra, and outflow obstruction. Results demonstrated that endometriosis was present in ten of 13 women with functioning endometrium, patent tubes, and outflow obstruction, whereas it could be identified in only 16 of 43 women with no obstruction (77 versus 37%, P <.01). Similarly, eight of nine women with hematocolpos or hematometra had endometriosis, while only 18 of 47 with functioning endometrium but no hematometra/hematocolpos had it (89 versus 38%, P <.01). None of the eight women without endometrium had endometriosis. These data support the concept that an increase in retrograde menstruation will increase the likelihood of endometriosis.