Zhu Li-hua, Huang Li-li, Huang He-feng
Department of Family Planning, Women's Hospital, Zhejiang University School of medicine, Hangzhou 310006, China.
Zhonghua Yi Xue Za Zhi. 2003 May 25;83(10):819-22.
To determine the expression and location of estrogen and progesterone receptor isoforms in the endometrium after abortion and discuss the relationship between the changes of isoforms and prolonged uterine bleeding after medical abortion.
45 endometrium biopsy were obtained from 15 women with prolonged bleeding after medical abortion, 15 women with prolonged bleeding after vacuum aspiration and 15 without prolonged bleeding after vacuum aspiration as control group. Immunohistochemical staining intensity of ER alpha, ER beta, PR-A and PR-B in endometrium were compared among these groups, as medical abortion group, surgical abortion group and control group.
The endometrial ER alpha, ER beta, PR-A and PR-B H-Scores of medical abortion group were 166.7 (88.5), 161.5 (84), 180.0 (109) and 136.5 (119.0), The endometrial ER alpha, ER beta, PR-A and PR-B H-Scores of control group were 306.7 (45.9), 230.0 (75.0), 224.2 (57) and 389.6 (106.6). The endometrial ER alpha, ER beta, PR-A and PR-B H-Scores of surgical abortion group were 109.4 (114.6), 225.0 (120.0), 175.5 (225) and 50.0 (89.0). The endometrial ER alpha, ER beta, PR-B H-Scores of medical abortion group were significantly lower than those of control group. And in surgical abortion group ER alpha and PR-B H-Scores were significantly lower than those in control group. But there was no significant difference between ER beta H-Scores of surgical abortion group and control group. There were no significant differences of ER and PR isoforms level ratios of endometrial glands to endometrial stroma among three groups.
The decreased ER alpha, ER beta and PR-B levels in the human endometrium may be related to prolonged uterine bleeding after medical abortion by mifepristone accompanied with misopristol. The endometrial ER alpha, PR-B decreased in women after vacuum aspiration abortion may be related to abnormal prolonged uterine bleeding. The changes of endometrial ER, PR isoforms in glands and stroma were simultaneous after medical abortion and surgical abortion.
确定流产后子宫内膜中雌激素和孕激素受体亚型的表达及定位，并探讨亚型变化与药物流产后子宫出血延长之间的关系。
选取15例药物流产后出血延长的妇女、15例人工流产后出血延长的妇女以及15例人工流产后无出血延长的妇女作为对照组，获取45份子宫内膜活检组织。比较药物流产组、人工流产组和对照组子宫内膜中雌激素受体α（ERα）、雌激素受体β（ERβ）、孕激素受体A（PR-A）和孕激素受体B（PR-B）的免疫组化染色强度。
药物流产组子宫内膜ERα、ERβ、PR-A和PR-B的H值分别为166.7（88.5）、161.5（84）、180.0（109）和136.5（119.0）；对照组分别为306.7（45.9）、230.0（75.0）、224.2（57）和389.6（106.6）；人工流产组分别为109.4（114.6）、225.0（120.0）、175.5（225）和50.0（89.0）。药物流产组子宫内膜ERα、ERβ、PR-B的H值显著低于对照组。人工流产组ERα和PR-B的H值显著低于对照组。但人工流产组与对照组ERβ的H值无显著差异。三组子宫内膜腺体与间质中ER和PR亚型水平比值无显著差异。
米非司酮联合米索前列醇药物流产后，人子宫内膜中ERα、ERβ和PR-B水平降低可能与子宫出血延长有关。人工流产后妇女子宫内膜ERα、PR-B降低可能与子宫异常出血延长有关。药物流产和人工流产后子宫内膜腺体和间质中ER、PR亚型的变化是同步的。
