Sereepapong Wisan, Chotnopparatpattara Pichai, Taneepanichskul Surasak, Markham Robert, Russell Peter, Fraser Ian S
Department of Obstetrics and Gynaecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Hum Reprod. 2004 Mar;19(3):547-52. doi: 10.1093/humrep/deh123. Epub 2004 Jan 29.
Depot medroxyprogesterone acetate (DMPA) is a very popular hormonal contraceptive. Unpredictable bleeding disturbances are the main reasons for discontinuation and may be mediated through endometrial hormone receptors. This study was aimed to compare the expression of progesterone and estrogen receptors in the endometrium of bleeding DMPA users with that of amenorrhoeic DMPA users.
Subjects were recruited between April 2000 and January 2001. On the day of the third DMPA injection, 42 amenorrhoeic DMPA users and 42 DMPA users who had frequent or prolonged endometrial bleeding and were bleeding on that day were matched by age and body mass index. Endometrial biopsies were collected for immunohistochemical study of progesterone receptor A plus B (PRAB) and B alone (PRB) and estrogen receptor alpha (ERalpha) and beta (ERbeta) expression.
There were 23 adequate endometrial samples from each group. There were no differences in any of a series of comparisons of PRAB, PRB, ERalpha and ERbeta expression in glands or stroma between the groups. Serum estradiol and progesterone levels were also not different between the groups.
Endometrial PRAB, PRB, ERalpha and ERbeta expression in glands and stroma was not different between DMPA users who had frequent or prolonged bleeding and amenorrhoeic DMPA users.
醋酸甲羟孕酮长效注射剂（DMPA）是一种非常受欢迎的激素避孕药。不可预测的出血紊乱是停药的主要原因，可能通过子宫内膜激素受体介导。本研究旨在比较有出血情况的DMPA使用者与闭经的DMPA使用者子宫内膜中孕激素和雌激素受体的表达。
研究对象于2000年4月至2001年1月招募。在第三次注射DMPA当天，42名闭经的DMPA使用者和42名有频繁或长时间子宫内膜出血且当天正在出血的DMPA使用者按年龄和体重指数进行匹配。采集子宫内膜活检组织，用于孕激素受体A加B（PRAB）、单独的孕激素受体B（PRB）以及雌激素受体α（ERα）和β（ERβ）表达的免疫组织化学研究。
每组有23份足够的子宫内膜样本。两组之间在腺体或间质中PRAB、PRB、ERα和ERβ表达的一系列比较中均无差异。两组之间血清雌二醇和孕激素水平也无差异。
有频繁或长时间出血的DMPA使用者与闭经的DMPA使用者在腺体和间质中的子宫内膜PRAB、PRB、ERα和ERβ表达无差异。
