性激素在围绝经期异常子宫出血中的作用机制

摘要

围绝经期异常子宫出血(abnormal uterine bleeding,AUB)病因众多,主要包括子宫与宫腔局部因素,全身出凝血功能的异常与生殖内分泌轴的功能异常.性激素在三大因素中分别起到不同作用,涉及到的疾病包括功能性AUB、子宫内膜增生引起的AUB、应用性激素类药物引起的AUB等,上述疾病与性激素的量、时间、比例有关,根据性激素的作用机制可大致分为雌激素撤退性出血、雌激素突破性出血、孕激素突破性出血三类.%Abnormal uterine bleeding in perimenopa-usal women is mainly associated with uterine and u-terine cavity abnormalities, impaired coagulation function and disturbances of the hypothalamus-pitui-tary-ovary axis. Sex hormones play different roles in all causes. Disturbances of their level, action duration , and proportion may lead to functional AUB, AUB caused by endometrial hyperplasia, AUB caused by sex hormone drugs. The bleeding patterns mainly include estrogen withdrawal bleeding, estrogen breakthrough bleeding, and progesterone breakthrough bleeding.