Thomson John C, Redwine David B
Departments of Obstetrics and Gynecology, National Women's Health, Auckland, New Zealand.
J Reprod Med. 2005 Oct;50(10):745-58.
To determine the prevalence of chronic inflammation of the pelvic peritoneum, systemic inflammation and autoimmunity in chronic pelvic pain and to explore the significance of these findings and assess the response to treatment with immune modification.
Prospective, observational clinical studies from 2 centers were performed on 3,238 women presenting with pelvic pain to determine the prevalence of chronic inflammation by biopsy when endometriosis was absent. A second study included 40 women with chronic pelvic pain not resulting from endometriosis; immunologic investigations were carried out and therapy instituted.
Chronic inflammation of the peritoneum, while not evident in the absence of pelvic pain, was present in 15.7% of women with chronic pelvic pain. In the second group, 10% had histologic evidence of chronic inflammation, 55% demonstrated evidence of systemic inflammation, and 37.5% were found to have autoimmune disorders. Chronic inflammation of the vagina was found in 42.5% and polycystic ovary syndrome in 22% of those with systemic inflammation. Twelve of the 40 were subsequently treated, with considerable success, with immune-modifying drugs, hydroxychloroquine and methotrexate.
Chronic pelvic pain is frequently associated with systemic inflammation, including autoimmune diseases. Peritoneal chronic inflammation is sometimes also associated. It is often successfully treated with immune-modifying drugs.
确定慢性盆腔疼痛患者盆腔腹膜慢性炎症、全身炎症和自身免疫的患病率，探讨这些发现的意义，并评估免疫调节治疗的反应。
对来自2个中心的3238名盆腔疼痛女性进行前瞻性观察性临床研究，以确定在无子宫内膜异位症时通过活检确定慢性炎症的患病率。第二项研究纳入了40名非子宫内膜异位症引起的慢性盆腔疼痛女性；进行了免疫学调查并开始治疗。
腹膜慢性炎症在无盆腔疼痛时不明显，但在15.7%的慢性盆腔疼痛女性中存在。在第二组中，10%有慢性炎症的组织学证据，55%有全身炎症的证据，37.5%有自身免疫性疾病。在有全身炎症的患者中，42.5%发现阴道慢性炎症，22%发现多囊卵巢综合征。40名患者中有12名随后接受了免疫调节药物羟氯喹和甲氨蝶呤治疗，并取得了相当大的成功。
慢性盆腔疼痛常与全身炎症有关，包括自身免疫性疾病。腹膜慢性炎症有时也有关联。免疫调节药物治疗通常能取得成功。
