放置IUD后异常出血子宫内膜的基质金属蛋白酶酶谱分析

本文应用酶谱法,观察了正常月经周期及IUD异常出血时子宫内膜.经5h组织块培养后分泌的MMPs.结果可见月经周期的三个不同阶段MMPs的表达明显不同.与增生期及分泌期酶活性比较,月经期酶活性及种类显著增加.IUD异常出血时,多种MMPs的活性明显低于正常月经期.结果提示置IUD后引起的月经期延长和出血量增加可能与子宫内膜中MMPs酶量减少及其活性降低有关.     

应用宫内节育器的妇女沙眼衣原体感染与子宫内膜中铜含量的关系

目的:探讨女性生殖道沙眼衣原体(CT)感染与宫内节育器(IUD)种类及内膜中铜含量的关系。方法:用聚合酶链反应检测65例置含铜IUD及97例置不锈钢单环的妇女宫颈分泌物CT;对因症取出IUD的20例妇女,取器后刮取子宫内膜,用原子吸收分光光度法测子宫内膜铜含量。结果:放置含铜IUD者CT感染率(3.1%)明显低于置不锈钢单环者(12.3%),P<0.05;放置含铜IUD的妇女子宫内膜铜含量明显高于置不锈钢单环者(P<0.05)。结论:含铜IUD对生殖道CT感染有抑制作用。含铜IUD可能通过释放的铜离子来发挥抗CT作用。     

放置不同材料IUD_s后兔子宫内膜纤溶活性的改变

本文介绍兔一侧子宫内分别放置铜、钢、磁性物质及铜加6-氨基己酸(EACA)制成的宫内节育器(IUD),观察子宫内膜的纤溶变化。发现实验侧纤溶活性均明显高于对照侧,以铜为最明显。比较对照试验,铜IUD侧纤溶活性高于钢及磁(P<0.05),钢与磁之间无差异(P>0.05)。置含EACA铜IUD组分别于置器后7,14,28天后观察纤溶活性。7及14天组实验侧与对照侧纤溶活性无差异。28天后实验侧明显高于对照侧。用含EACA铜与无EACA的铜IUD进行对比,7天组实验侧纤溶活性低于对照侧(0.05相似文献   

子宫内膜酶与宫内节育器

<正> 酶是细胞内具有特异性及高催化效能的蛋白质。细胞内酶的活性变化直接关系到细胞、组织和器官的生理功能。子宫内膜中有多种酶,对其深入研究,有助于揭示生殖功能并可阐明宫内节育器(IUD)所致的出血机制。本文对正常子宫内膜酶及放置IUD后子宫内膜酶的变化作一综述。     

放置IUD后宫腔微环境的研究

目的 :研究长期放置IUD子宫局部免疫功能的变化。方法 :以放置 5～ 2 0年惰性和含铜宫内节育器 (IUD)共 6 2例为研究组 ,以正常妇女 2 7例为对照组 ,以肿瘤坏死因子 α(TNF α)、白细胞介素 2 (IL 2 )、分泌型IgA(SIgA)和T淋巴细胞为指标。结果 :宫腔冲洗液TNF α浓度在惰性IUD组、含铜IUD组与对照组之间均未见明显差异。含铜IUD组宫腔冲洗液IL 2浓度显著低于对照组 (P <0 0 5 ) ,SIgA浓度亦显著低于对照组 (P <0 0 5 )。含铜IUD组子宫内膜组织抑制或杀伤T淋巴细胞 (CD+8淋巴细胞 )明显多于惰性IUD组和对照组 ;而辅助性T淋巴细胞 (CD4+ 淋巴细胞 )少于对照组 ,与惰性IUD组差异无显著性。结论 :长期放置IUD对子宫局部免疫功能有不同程度的影响     

放置宫内节育器对子宫内膜血管内皮生长因子及其激酶受体表达及微血管密度变化的影响

目的探讨放置固定式带铜宫内节育器(FCu-IUD)和含吲哚美辛FCu-IUD(FICu-IUD),对子宫内膜组织中血管内皮生长因子(VEGF)及其激酶受体(KDR)表达以及微血管密度(MVD)变化的影响及意义.方法采用免疫组化法及原位杂交法,检测放置FCu-IUD妇女(10例,FCu-IUD组)及放置FICu-IUD妇女(10例,FICu-IUD组)放置IUD前后子宫内膜VEGF、VEGF mRNA及KDR的表达,并计数子宫内膜MVD.结果 FCu-IUD组放置IUD后,VEGF及KDR蛋白为0.568±0.027,0.244±0.022,均高于放置IUD前的0.357±0.032,0.215±0.029,放置IUD前后比较,差异有显著性(P<0.05).FCu-IUD组放置IUD前VEGF mRNA表达为0.359±0.022,低于放置IUD后的0.425±0.019,放置IUD前后比较,差异有显著性(P<0.05).FICu-IUD组放置IUD前后VEGF、KDR蛋白及VEGF mRNA表达比较,差异无显著性(P>0.05). FCu-IUD组放置IUD后MVD为19.8±4.8,明显高于放置IUD前的15.4±2.8,且与VEGF蛋白的表达呈正相关关系(r=0.847,P<0.01).FICu-IUD组放置IUD前后MVD比较,差异无明显性(P>0.05).结论放置FCu-IUD可促进子宫内膜VEGF及KDR的表达,FICu-IUD可抑制子宫内膜VEGF及KDR的生成.VEGF及KDR可能参与了FCu-IUD 及FICu-IUD所引起的子宫内膜微血管结构和功能的改变.     

缓释18-甲基炔诺酮宫内节育器对大鼠子宫及主要脏器的影响

本文研究新制缓释18-甲基炔诺酮宫内节育器(LNGR-IUD)对大鼠子宫及主要脏器的影响。实验分四组:1.含药IUD组;2.不含药硅橡胶IUD组;3.手术对照组;4.正常对照组。结果表明,含药IUD组子宫内膜早期(15及30天时)有轻度炎症反应,60天时炎症反应逐渐消退,90天恢复正常。与不含药IUD组及手术对照组无差异。含药组子宫内膜呈乳头状增生与分泌,亦随时间延长而渐减轻。内膜血管仅早期呈现充血反应,30天后逐步消失。各组全身主要脏器皆未见病变,含药IUD组各期卵巢中见到正常卵泡发育及黄体形成。     

放置不同材料IUD后兔子宫内膜水解酶组织化学的观察

本文介绍不同材料(不锈钢、铜及磁)制成的宫内节育器IUD引起子宫内膜ACP(酸性磷酸酶)、AKP(碱性磷酸酶)及ATPase(三磷酸腺苷酶)的活性改变,并提出其评定标准。结果显示铜IUD引起上述三种酶的变化较其他几种IUD明显得多,它能使ACP活力增加,AKP和ATPase活力降低。这也可能是铜IUD避孕效果好而出血量多的原因之一。这些结果提示不同材料的IUD所引起的避孕机理可能不尽相同。至于ACP在IUD的避孕机理中和在引起出血的副反应中,其因果关系如何尚有待进一步研究。     

消炎痛对人子宫内膜细胞摄取前列腺素E_2的影响

<正> 放置宫内节育器(IUD)后的一个最常见的副反应是子宫异常出血。近十多年来,这种副反应与放置IUD后子宫前列腺素(PGs)的生物合成异常以及子宫对PGs的敏感性增强的关系愈来愈明确。临床使用消炎痛PGs合成酶抑制,能有效地防治IUD子宫异常出血,但具体的作用途径尚不明确。PGs对子宫内膜细胞产生效应,首先必须由子宫内膜细胞将PGs摄入细胞内。本文用细胞摄取功能测定法,观察人子宫内膜细胞摄取[~3H]PGE_2的功能状态及其在消炎痛作用后的变化,从中探索消炎痛影响子宫内膜细胞与     

子宫内膜异位症患者血清和腹腔液中明胶酶活性测定及其临床意义

目的通过检测子宫内膜异位症患者血清及腹腔液中明胶酶(MMP-2、MMP-9)的活性,探讨其在子宫内膜异位症发病中的作用.方法2004年6月至2005年6月对吉林大学第二医院妇科60例子宫内膜异位症患者采用含SDS-明胶的聚丙烯酰胺凝胶电泳为基础的酶谱法,检测血清和腹腔液MMP-2、MMP-9活性,其中Ⅰ～Ⅱ期22例,Ⅲ～Ⅳ期38例,良性卵巢囊肿患者20例为对照组.结果子宫内膜异位症患者血清和腹腔液中MMP-2、MMP-9明显高于对照组(P＜0.05).随着子宫内膜异位症(EMs)分期的增加,其血清和腹腔液中MMP-2表达量呈上升趋势,且血清中EMsⅢ～Ⅳ期组MMP-2酶活性比对照组增高2倍(P＜0.01).结论酶谱法是诊断子宫内膜异位症的有效手段,内异症患者明胶酶MMP-2、MMP-9的表达水平增高,其在子宫内膜异位症的发生发展中具有重要作用.     

吲哚美辛宫内节育器的主要药效学研究

本文应用放射免疫法测定吲哚美辛 IUD对离体大鼠子宫匀浆中前列腺素类物质(PGs)释放的影响 ,用光镜和电镜观察放置吲哚美辛 IUD后大鼠子宫内膜的形态学变化 ,并测定吲哚美辛 IUD在大鼠子宫内的动态释放规律。结果表明 :吲哚美辛组 PGs释放约为铜组的 1 / 5～ 1 / 1 0 (P<0 .0 5 ) ,而且吲哚美辛抑制 PGs释放的作用随药物浓度增加而增强。铜组和硅橡胶组 PGs释放均有随时间累积而增加趋势 ,而吲哚美辛组无此表现。 6KF和 TXB2 的比值 ,吲哚美辛组和硅橡胶组均 <1 (0 .6～ 0 .8) ,而铜组则均 >1 (1 .3～ 2 .1 )。组织学观察 ,铜 IUD组可见子宫内膜组织充血水肿 ,微血管以扩张为主 ,吲哚美辛 IUD组则无充血水肿表现 ,微血管以正常和收缩状态为主。吲哚美辛 IUD在大鼠子宫内药物释放量 3 d后稳定 ,释放速度稳定递减 ,符合均质型缓释规律。     

记忆合金药铜宫内节育器对兔子宫内膜超微结构的影响

目的:研究记忆合金药铜节育器对兔子宫内膜超微结构的影响。方法:雌性日本大耳白兔随机分为3组,实验组记忆合金药铜节育器和对照组不锈钢药铜节育器各18只,假手术对照组6只,通过手术放置节育器于兔子宫腔内,术后1、3、6个月处死兔,取出子宫,扫描和透射电子显微镜下观察放置节育器处的子宫内膜。结果:放置节育器的兔子宫内膜均可见上皮细胞的形态和结构发生改变。扫描电子显微镜下,上皮细胞的变化随节育器放置时间和受压程度的增加而增加,可逐渐出现细胞表面压平、变形,微绒毛稀疏、消失;较长时间放置,可引起上皮细胞损坏、脱落。透射电子显微镜下2种节育器引起的细胞形态和结构的改变相似,主要是内质网扩张,细胞核肿胀,质膜溶解,严重的可见上皮细胞脱落现象。细胞内超微结构的损伤亦随节育器放置时间和受压程度的增加而加重。但基膜始终损伤较轻微,基膜下的间质未观察到明显异常的形态学变化。结论:记忆合金药铜节育器与不锈钢药铜节育器对兔子宫内膜超微结构的影响相似。     

The effect of a copper IUD and various "inert" Iuds on the histological picture of the rabbit endometrium during early pseudopregnancy and pregnancy.

The influence of a copper IUD and two "inert" IUDs on the histological picture of the rabbit endometrium during early pseudopregnancy and early pregnancy was studied. The copper IUD markedly inhibited the endometrial maturation during the first five days of both pseudopregnancy and pregnancy. The "inert" IUDs had no such effect. The copper IUD prevented the normal response of the rabbit uterus to 17-beta-estradiol in castrated animals. The observed effects of the copper IUD might seriously interfere with the normal process of implantation.     

家兔子宫内膜的形态学特点与含铜宫内节育器对子宫内膜的影响

对正常家兔不同时期和放置铜丝及尼龙丝家兔的子宫内膜进行了组织学及组织化学的观察。结果为:正常家兔不同时期的子宫内膜形态特点主要表现在内膜上皮的生长与分化上,硷性磷酸酶活性变动较大,以妊娠时最高;乳酸脱氢酶、琥珀酸脱氢酶、酸性磷酸酶变化不大。家兔在增殖期放置铜丝的子宫内膜,其上皮及粘膜的乳头腺体呈不典型增殖期生长或萎缩;间质呈不典型分泌期改变并伴有轻度炎症,十分之二有严重炎症及积脓。本文对正常家兔子宫内膜的组织学特点及铜离子的避孕机理进行了讨论。     

Expression of alpha4beta1 and alphavbeta3 integrins in the endometrium of women using the T200 copper intrauterine device

OBJECTIVE: To investigate the expression of alpha4 and beta3 integrin subunit levels in the endometrium of healthy women and copper intrauterine device (IUD) T200 users. DESIGN: Case control study. SETTING: An academic teaching hospital and a primary care clinic. PATIENT(S): Thirteen copper IUD users and 13 normal fertile women.Intervention(s): Timed endometrial biopsies during the mid-secretory phase (days 20 to 24). MAIN OUTCOME MEASURE(S): Histologic dating of endometrium and immunohistochemical staining intensity of alpha4 and beta3, using the semiquantitative immunohistochemical score (HSCORE). RESULT(S): All endometrial biopsies consistent with menstrual dates were examined for integrin expression (beta3 and alpha4). No difference in alpha4 integrin expression was found between IUD users and controls in both luminal and glandular epithelium. In fertile controls, alphavbeta3 staining was present in 100% and 38.4% of glandular and luminal epithelium, respectively. In contrast, only 61.5% of the IUD users had any alphavbeta3 staining in the glandular epithelium and only 53.9% in the luminal epithelium. The intensity of immunoreactivity between the two groups (mean HSCORE) did not differ significantly. CONCLUSION(S): Proportionately, significantly fewer women using copper IUD had positive alphavbeta3 immunoreactivity in the glandular epithelium of mid-secretory endometrium.     

The effect of a copper iud and "inert" iuds on the incorporation of 3-h-thymidine and 5-3-h-uridine into the endometrium of the rabbit after stimulation with human chorionic gonadotropin.

The present investigation studied the influence of different types of intra-uterine devices (IUDs) especially that of a copper IUD, on the incorporation of 3-H-thymidine and 5-3-H-uridine into the endometrium of the rabbit. "Inert" IUD. In non-stimulated rabbits, the incorporation of 3-H-thymidine was increased in the copper influenced horn. The incorporation of 3H-thymidine in control and Cu-IUD-containing horns reached a maximum at 48 hours after HCG stimulation, but was significantly lower in the copper-containing horn than in the control horn. On the fifth day of pseudopregnancy, the incorporation of 3-H-thymidine was significantly higher in the copper IUD-containing horn. The total amount of DNA in the endometrium increased during early pseudopregnancy, but this increase was markedly reduced in the presence of copper. The copper IUD had no influence on the rate of incorporation of 5-3-H-uridine in non-stimulated rabbits, whereas it caused a higher incorporation on the fifth day of pseudopregnancy.     

家兔子宫内膜对荧光标记的雌激素和孕激素的结合反应及在宫腔内放置铜丝或尼龙丝后的改变

利用荧光雌激素及孕激素标记法观察了正常家兔及宫内放置铜丝、尼龙丝家兔一月后子宫内膜的雌、孕激素受体的荧光结合反应。结果,正常家兔子宫内膜雌、孕激素受体的荧光分布和含量随兔龄及生理周期而不同:增殖早期主要分布在上皮胞浆内;增殖晚期含量增加;分泌期间质细胞及血管亦有出现;妊娠早期主要在子宫内膜腔面。在胎盘滋养叶细胞中,孕激素受体荧光大大超过雌激素受体荧光。宫内放置铜丝后,增殖期子宫内膜的上皮细胞肿胀紧挤,细胞境界模糊,雌、孕激素受体荧光出现凝聚碎片或呈絮状,部分荧光消失,间质亦出现荧光反应。而宫内放置尼龙丝侧的变化甚少。提示铜离子可影响雌、孕激素受体蛋白。本文对铜离子在避孕机理中的意义进行了讨论。     

The effect of IUD on endometrial blood vessels--correlation between vascular changes and bleeding]

In order to examine the causes of endometrial bleeding following IUD insertion, 22 samples of endometrium from women with an IUD in place for between 1-20 years or more and 10 cases of endometrium without an IUD and with normal menstrual cycles as controls were studied. The quantitative histologic method was utilized to demonstrate the correlation between vascular changes and clinical bleeding. The results indicate that the concentration and expansion of microvascularity, especially the capillary, venule, and venous sinus, increased significantly in most of the IUD-exposed endometriums (75%) as compared with controls (p0.01). The remarkable changes in vessels correlated with clinical bleeding were increased density, obvious dilatation, defect, and rupture of the superficial venous sinus. Mechanical damage, degeneration, necrosis, and denudation of surface endometrium exposed to the IUD could be the direct cause of clinical bleeding.