甲状腺功能障碍背景下女性子宫内膜增生的临床特点

V. Benyuk, V. Kurochka, Abedi Astaneg Niki, I. Usevych, Y. Kravchenko
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摘要

目的:明确育龄妇女伴甲状腺功能减退的子宫内膜增生的临床特征。材料和方法。在我们的监测下,有180名患有子宫内膜增生的妇女。在120名妇女中,子宫内膜病理与新诊断的甲状腺功能减退有关。将甲状腺功能障碍患者分为两组:无症状者48例;有症状者——45名妇女;症状轻微的补偿病人,27人对照组为无甲状腺病理的子宫内膜增生患者60例。对所有患者的躯体和妇科记忆、性激素和甲状腺激素浓度、子宫内膜组织学检查结果进行分析。结果发现:无甲状腺病理的高泌乳素血症妇女的年龄比有甲状腺病理的高泌乳素血症妇女的年龄小;子宫内膜增生妇女的甲状腺功能减退与体重的频繁增加有关,但与肥胖无关;在子宫内膜增生和甲状腺功能减退的女性中,最常见的伴随病理是乳腺病变,几乎每三名患者中就有一名被诊断为乳腺病变。子宫内膜增生的妇女出现多囊卵巢综合征和高泌乳素血症等内分泌疾病的频率在甲状腺功能减退的情况下几乎增加了两倍。在子宫内膜增生和甲状腺功能减退的情况下,雌二醇浓度显著降低,促性腺激素(黄体生成素和促卵泡激素)水平保持不变,最低值是在有症状性甲状腺功能减退的妇女中确定的。61.5%的子宫内膜增生患者诊断为慢性子宫内膜炎,其检出率不依赖于甲状腺功能障碍。甲状腺功能障碍参与了子宫内膜增生过程的发生机制,是筛查子宫内膜病理女性甲状腺功能状态的基础。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical characteristics of women with endometrial hyperplasia on the background of thyroid dysfunction
The objective: to define the specificities of clinical characteristics in women of reproductive age with endometrial hyperplasia associated with hypothyroidism.Materials and methods. There were 180 women with endometrial hyperplasia under our supervision. In 120 women, the pathology of endometrium was associated with newly diagnosed hypothyroidism. The patients with the thyroid dysfunctions were divided into the following groups: asymptomatic persons – 48 cases; symptomatic ones – 45 women; compensated patients with mild symptoms – 27 individuals. The control group consisted of 60 patients with endometrial hyperplasia without thyroid pathology.The data of the somatic and gynecological anamnesis, the concentration of sex hormones and thyroid hormones, the results of histological examination of the endometrium were analyzed in all the women.Results. The following data were found: the age of women with hyperprolactinemia without thyroid pathology is younger than the age of those with hyperprolactinemia and thyroid pathology; hypothyroidism in women with endometrial hyperplasia is contingent on frequently growing body weight, but not obesity; the most common concomitant pathology in women with endometrial hyperplasia and hypothyroidism was mastopathy which was diagnosed almost in every third patient. The frequency of such endocrine pathologies as polycystic ovary syndrome and hyperprolactinemia in women with endometrial hyperplasia has almost increased twice in the presence of hypothyrosis. In case of endometrial hyperplasia and hypothyrosis there was a significant decrease of estradiol concentration with a preserved level of gonadotropic hormones (luteinizing hormone and follicle-stimulating hormone), and the lowest values were defined in women with symptomatic hypothyroidism. Chronic endometritis, the detection rate of which does not depend on thyroid dysfunction, was diagnosed in 61.5 % patients with endometrial hyperplasia.Conclusions. Thyroid dysfunction is involved in the mechanisms of development of hyperplastic processes of the endometrium, which is the basis for screening the functional state of the thyroid gland in women with endometrial pathology.
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