Belaisch J
Hôpital Saint-Vincent de Paul, Service de Gynécologie-Obstétrique, Paris.
Rev Fr Gynecol Obstet. 1991 Feb 25;86(2 Pt 2):175-80.
The effects of female sex hormones upon the veins of lower limbs are well-known particularly since women use widely estroprogestatives or progestatives drugs. The knowledge of the mechanism of action of hormones and particularly of steroids upon cells receptors has been dramatically improved and allowed to explain some endocrinologic states till now misunderstood. In return, intimate mechanism of the hormonal disturbances of venous function is still mysterious. The published studies are conflicting or radically inconsistent with basic notions of hormonal activity which seemed established. The presence of hormonal steroids receptors in endothelial cells from the rabbit aorta intima has been confirmed and the reality of these cytosolic receptors from the pelvic and lower limbs venous tissues has been demonstrated by biochemical methods in some publications. But other authors have pointed out the lack of these receptors on pelvic vessels by using immunohistochemical localization and discovered progesterone receptors in large vessels and myocardial fibers nuclei. Extremely fine effects of natural and synthetic estrogens, that coagulation specialists try to understand, are distorted by rough descriptions which only consider the peculiar but not whole therapeutic aspects. This problem is at the border of several specialties and synthesis have to be achieved. But before the year 2000 substantial progress will surely be carried out with regard to the importance of the lower limbs and genital sphere venous pathology for women (and also for men) and substantial therapeutic consequences will follow.
女性性激素对下肢静脉的影响是众所周知的,尤其是因为女性广泛使用雌激素孕激素或孕激素药物。关于激素,特别是类固醇对细胞受体的作用机制的认识有了显著提高,这使得人们能够解释一些迄今为止被误解的内分泌状态。然而,静脉功能激素紊乱的内在机制仍然神秘。已发表的研究相互矛盾,或者与似乎已确立的激素活性基本概念完全不一致。一些出版物通过生化方法证实了兔主动脉内膜内皮细胞中存在激素类固醇受体,并证明了盆腔和下肢静脉组织中这些胞质受体的存在。但其他作者通过免疫组织化学定位指出盆腔血管上缺乏这些受体,并在大血管和心肌纤维细胞核中发现了孕激素受体。凝血专家试图理解的天然和合成雌激素的极其细微的作用,却被只考虑特殊而非整体治疗方面的粗略描述所歪曲。这个问题处于多个专业领域的边缘,必须进行综合研究。但在2000年之前,关于下肢和女性(以及男性)生殖系统静脉病理学的重要性肯定会取得实质性进展,随之而来的将是重大的治疗成果。