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子宫内膜异位症(EMs)是一种雌激素依赖性疾病,孕激素能抑制异位内膜细胞的生长,故临床常应用孕激素类药物缓解症状并延缓复发,但在EMs中存在孕激素抵抗现象,导致患者不孕、流产率增高,以及对大剂量孕激素治疗效果欠佳。孕激素的作用机制复杂,发生孕激素抵抗的机制尚不完全清楚,可能为多因素、多水平。本文从孕激素受体及HOX基因表达改变两方面阐述发生孕激素抵抗的机制。
Endometriosis (EMs) is an estrogen-dependent disease, progesterone can inhibit the growth of ectopic endometrial cells, it is often used in clinical progesterone drugs to relieve symptoms and delay relapse, but there is the presence of pregnancy in EMs Hormone resistance, leading to infertility in patients, increased abortion rates, and the effect of high-dose progesterone treatment is poor. The mechanism of action of progesterone is complex, and the mechanism of progestin resistance is not fully understood, which may be multifactorial and multi-level. This article describes the mechanism of progestin resistance from two aspects of progesterone receptor and HOX gene expression changes.