Роль імунних механізмів у розвитку доброякісної патології матки

Abstract

The objective: to study the role of immunological mechanisms in the development of adenomyosis with endometrial hyperplasia in women of reproductive age and the phased introduction of an integrated hormonal and immunostimulating therapy. Patients and methods. The authors investigated the effect of hormone therapy on the immune system of women with adenomyosis and endometrial hyperplasia: We evaluated the influence of hormone therapy 135 women of reproductive age with adenomyosis in combination with endometrial hyperplasia: group i - 45 women using a progestogen (6 months); II – 45 women who took agonist of gonadotropin-relesing hormone (a-GnRH) (6 months) III – 45 women who received complex therapy involving a-GnRH during the first 6 months and immunomodulator intramuscularly every other day No. 20, with subsequent use of tablets of 0.15 g of 1 times a week (course – 6 months), then in the next 6 months was used progestogen in the second phase of the menstrual cycle from 16 to 25день. Evaluation of indicators of health status were performed after 3, 6 and 12 months of therapy. NK (natural killer) activity was estimated by the method of Hamaoka modification N.T. Rekowа. Results.We studied the role of immune system in the pathogenesis of adenomyosis, endometrial hyperplasia and endometrial and combined pathology of endo- and myometrium in women of reproductive age by assessing the cytotoxic activity of NK-cells, since this component determines its oversight role in the dynamics. Identified new pathogenic mechanisms in the development of benign pathology of the uterus due to the dysfunction of the immune system, especially expressed in terms of reduction of cytotoxic index of NK-cells. Conclusion. Developed a comprehensive phased hormone therapy for women of reproductive age with combined benign uterus pathology, including immunomodulator and the estimation of influence on parameters of immune status in the dynamics of observation. Key words: NK-cells, benign uterine pathology, comprehensive hormone therapy, Progestogens, -GnRH.