激素暴露对子宫内膜金属基质蛋白酶及其组织抑制物表达的影响

目的：了解联合激素替代治疗（HRT）对子宫内膜金属基质蛋白酶（MMP）9及其组织抑制物（TIMP）1表达的影响,探讨其表达与HRT妇女不规则子宫出血之间的关系。方法：宫腔镜活组织检查提取57例HRT合并不规则子宫出血妇女出血期间和出血停止后3月子宫内膜（A1,A2组）,以同期HRT但不合并出血的绝经期妇女20例（B组）和未接受HRT绝经期妇女20例（C组）作对照。免疫组织化学标记观察MMP-9、TIMP-1蛋白质阳性表达及其分布。结果：不规则出血妇女中MMP-9低水平表达,与其他各组之间没有显著性差异,但其阳性细胞更多地分布于蜕膜化的基质细胞浆中。暴露于激素治疗妇女不规则子宫出血发生率显著增高,子宫内膜中TIMP-1表达显著高于未接受HRT的绝经期妇女。HRT伴出血妇女子宫内膜中TIMP-1表达均显著性增加,同一个体在出血期间的TIMP-1表达也显著高于出血停止后3月（χ^2=5.643,P=0.003）。接受HRT但从未出现不规则出血妇女子宫内膜TIMP-1表达也明显高于未接受HRT妇女（χ^2=4.411,P=0.036）。结论：HRT伴不规则出血妇女子宫内膜TIMP-1表达显著增加,与MMP-9之间平衡破坏,与正常月经出血表达方式完全不同。

Influence of Hormone Therapy Exposure on Endometrial Expression of Matrix Metalloproteinase and Their Tissue Inhibitor

Objective:To determine how hormone replacement therapy(HRT)exposure alters endometrial production of matrix metalloproteinase(MMP)-9 and their tissue inhibitor of metalloproteinase(TIMP)-1 and to assesse the relationship between MMP-9,TIMP-1 production and irregular uterine bleeding patterns in HRT users.Methods:Endometrial biopsies had been harvested from 57 postmenopausal women taking combined HRT during(group A1)and outside(group A2)irregular bleeding by hysteroscope.A comparative observation was conduct...