Pittaway D E, Wentz A C
J Reprod Med. 1984 Oct;29(10):712-6.
More than 100 years after the first description of endometriosis, the pathophysiology of the disorder still remains an enigma. In addition to infertility, an increased frequency of clinically apparent spontaneous abortions (32% vs. 8-15% in the normal population and 19% in the infertile one) has been found in women with endometriosis and secondary infertility. Treatment of endometriosis with conservative surgery, danazol or both results in a frequency of spontaneous abortion within the range of the normal population's. Although the factors involved in the pathophysiology of endometriosis are probably multiple, abnormal corpus luteum function is a common mechanism that might explain both the infertility and the spontaneous abortions. Several studies suggested a relationship between endometriosis and corpus luteum function, which may be mediated by prostaglandins. However, not all the data have been supportive. We developed a hypothetical scheme (modified from Drake) that outlines possible mechanisms of endometriosis mediated by the adverse effects of increased prostaglandins. Further investigation of this scheme may provide new information about the pathophysiology of endometriosis.
在子宫内膜异位症首次被描述100多年后，该疾病的病理生理学仍然是一个谜。除了不孕之外，子宫内膜异位症和继发性不孕的女性中，临床上明显的自然流产发生率增加（32%，而正常人群为8 - 15%，不孕人群为19%）。用保守手术、达那唑或两者联合治疗子宫内膜异位症后，自然流产率在正常人群范围内。尽管子宫内膜异位症病理生理学涉及的因素可能是多方面的，但黄体功能异常是一个可能解释不孕和自然流产的常见机制。几项研究表明子宫内膜异位症与黄体功能之间存在关联，这可能由前列腺素介导。然而，并非所有数据都支持这一点。我们制定了一个假设方案（改编自德雷克），概述了由前列腺素增加的不利影响介导的子宫内膜异位症的可能机制。对该方案的进一步研究可能会提供有关子宫内膜异位症病理生理学的新信息。
