国际生殖健康/计划生育杂志

国际生殖健康/计划生育 ›› 2013, Vol. 32 ›› Issue (2): 132-135.

• 综述 • 上一篇    下一篇

局部高雌激素与子宫内膜异位症

郑 娟 ,祁晓晨, 崔毓桂   

  1. 210029 南京医科大学第一附属医院生殖医学中心
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2013-03-15 发布日期:2013-03-15
  • 通讯作者: 崔毓桂

Local High Level of Estrogen and Endometriosis

ZHENG Juan，QI Xiao-chen，CUI Yu-gui   

  1. Center of Reproductive Medicine，First Affiliated Hospital，Nanjing Medical University，Nanjing 210029，China（ZHENG Juan，QI Xiao-chen，CUI Yu-gui）
  • Received:1900-01-01 Revised:1900-01-01 Published:2013-03-15 Online:2013-03-15
  • Contact: CUI Yu-gui

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摘要： 子宫内膜异位症（EMs）是雌激素依赖性疾病。除传统的内分泌机制外，EMs发生、发展与异位子宫内膜类固醇激素自分泌、细胞因子密切相关，表现在在位内膜和异位内膜芳香化酶的过表达，而正常子宫内膜芳香化酶低表达或无表达。异位子宫内膜组织芳香化酶的表达受前列腺素E2（PGE2）、类固醇生成因子1（SF-1）和白细胞介素6（IL-6）等多种因子的调节。同时，免疫因子和环境因素亦可引起异位子宫内膜组织芳香化酶表达升高，导致局部雌二醇（E2）合成增多。此外，异位组织中灭活E2的17β-羟类固醇脱氢酶2和雌激素硫酸转移酶表达下降，使E2分解代谢减少。由此，异位灶局部形成一个高水平的E2微环境是EMs的重要机制。

关键词: 子宫内膜异位症, 雌激素类, 受体, 雌激素, 芳香酶

Abstract: Endometriosis is a common estrogen-dependent gynaecological disease. In addition to the well-known endocrine mechanism，secretion of steroid hormones and cytokines by endometriotic cells is associated with the pathogenesis of endometriosis. Aromatase shows higher expression in endometriosis compared with normal endometrium. Aromatase expression in ectopic endometrium is regulated by various cytokines，such as prostaglandin E2（PGE2），steroidogenic factor 1（SF-1），interleukin 6 （IL-6） and so on. Immune and environmental factors can also stimulate aromatase expression and consequently increase estradiol biosynthesis in endometriotic tissue. Additionally，the decreased expressions of 17β-hydroxysteroid dehydrogenase （17beta-HSD） type 2 and sulfate transferase in endometriotic tissues result in the reduced deactivation of E2. In summary，high E2 production and low E2 deactivation may stimulate the growth of endometriotic lesions.

Key words: Endometriosis, Estrogens, Receptors, estrogen, Aromatase