ENDOMETRIOSIS IN ASSOCIATION WITH MULLERIAN ANOMALIES
ENDOMETRIOSIS IN ASSOCIATION WITH MULLERIAN ANOMALIES
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DOI：
10.1159/000292349
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发表时间：
1995-01-01
影响因子：
2.1
通讯作者：
GOKMEN, O
中科院分区：
文献类型：
--
作者：
UGUR, M;TURAN, C;GOKMEN, O
关于子宫内膜异位症的病因和发病机制，已经提出了许多理论。月经逆行、体腔化生和苗勒氏管残余的理论都属于其中。为了查明苗勒氏管异常患者的患病率是否较高，并检验这些理论，我们回顾了我们生殖内分泌诊所在 1989 年至 1994 年间建立的病例记录。研究组包括苗勒管异常患者 (n = 186)，而对照组包括没有苗勒管异常的患者 (n = 3,240)。研究组中子宫内膜异位症的发生率为 186 例中的 37 例 (19.8%)，而对照组为 3,240 例中的 619 例 (19.1%) (p > 0.05)。 1 名无功能子宫内膜的患者出现子宫内膜异位症。与非阻塞性异常相比，阻塞性异常与子宫内膜异位症的相关性更大（p < 0.001）。与对照组相比，非阻塞性异常的患病率并未更高（p > 0.05）。这些结果表明，子宫内膜异位症在苗勒管异常患者中并不常见，但流出道阻塞是一个重要的促成因素。对苗勒管异常患者的评估为支持月经逆行和体腔化生理论提供了证据，但反对胚胎发生过程中苗勒管系统分化或迁移的发育缺陷可能存在的关系。
There have been many theories proposed regarding etiology and pathogenesis of endometriosis. The theories of retrograde menstruation, celomic metaplasia, and mullerian remnants are among these. In order to find out whether a higher prevalence exists in patients with mullerian anomalies and to test these theories, we reviewed the case records of our reproductive endocrinology clinic set up between 1989 and 1994. The study group included patients with mullerian anomalies (n = 186) whereas the control group consisted of patients without mullerian anomalies (n = 3,240). The frequency of endometrioses was 37 of 186 (19.8%) in the study group as compared with 619 of 3,240 (19.1%) in the controls (p > 0.05). In 1 patient without functioning endometrium endometriosis was demonstrated. Obstructive anomalies were associated more with endometriosis as compared with nonobstructive anomalies (p < 0.001). The nonobstructive anomalies did not present a higher prevalence as compared with controls (p > 0.05). These results show that endometriosis is not more frequent in patients with mullerian anomalies as a whole, but ouflow obstruction is an important contributing factor. Evaluating patients with mullerian anomalies contributes proof in favor of the theories of retrograde menstruation and celomic metaplasia, but against a possible relation of a developmental defect of differentiation or migration of the mullerian duct system during embryogenesis.