Добавил:
Опубликованный материал нарушает ваши авторские права? Сообщите нам.
Вуз: Предмет: Файл:

Эндокринная гинекология. Татарчук Т.Ф

..pdf
Скачиваний:
427
Добавлен:
14.06.2014
Размер:
3.65 Mб
Скачать

192

-!% % !

4 % *. % - -

2 ! 2 2 #- # /- 1 *. ! / # 2 (Druckmann R., 2001).

2 /, 1 ( ". ., 1999)

' ', $- -

1- 2- (Th-1 Th-2) % !

+ ! (/2-12, - , /2-10),

(% ) -

( . 5).

! ! % * , # 1 - ! ' % #. / % 0-

2 1 % *-

2 1 0 (Grossman C.J. et al., 1994; Kincade P.W. et al., 2000).

— ), * — , — ) ,. ) , 0 — % #-! (% # !) )

5. ! (Druckmann R., 2001 / !

!)

191

"9. % !

193

6 ! / % * #,

! + % / * 2 % !

% % ' / 1 #

(Blum M. et al., 1990; Grossman J. et al., 1994).

)2 2. ! + / ', ,

* % !# % (Blum M. et al., 1990; Grossman C.J. etal., 1994).

2 * -

% * , / * / ! -

" , : / . % /-

1 1 (Grossman C.J. et al., 1994; Lemola—Virtanen R. et al., 1997).

! / . / 1 - % / !, , ! ! 1 %

(Grossman C.J. et al, 1994; Lemola—Virtanen R. et al, 1997).

-% 2 * + * Ig M + * 0 * Ig- # / Ig Ig M / 0 /

% (Milson " Nilsson L.A. et al., 1991; Molland J.G. et al., 1990).

0 %, 0 % * . % . % 0 ! - 2 * # # % 1 ' 1 / . 1 , 1 -

( 3). 0 %

/ ! 2 / % ., ! !*. ! ' 2

2 % (White H.D. et al, 1997).

2 /, 0 % / + * / 1 ,

, 2 * / . # (Brunelli R. et al., 1996;

Grossman C.J. et al., 1994).

& % . !* ! % #. , -

%, % *. ' * / 1, 2

0 % (Grossman C.J. et al., 1994).

# ! 1 #, * ! -% 2 *.

, % #/

%-*. (GM-CSF), ,7-1

*.

(TGH-J3), / *

*. 0 , / ! ' .

* (% *.) / %

# (Grossman C.J. et al., 1994).

( 0 !# ! 1 (3)

! ' * * /. 3 * %-

1 #, . . 0 / ! ! 0

% ( ". ., 1999; Albrecht A.E. et al, 1996).

%, % % # * 1 1 #

- 1 % 2 # * 1. 6 — 0 ' - % ! - % # !1 ! CDg+T-

( ". ., 1999; Albrecht A.E. et al., 1996). -

' 2=! , % +

192

194

-! % % !

# !, *. ! . - 1, ,

/ ! 1 / , 2 % ! /-

* . 0 ! % % / !. ) ! % 1 (Lemola—Virtanen R. et al., 1997)

/ * 2 * 1 #

* (0 % *) /.

2 /, *. ! % ! / /-

1 2 * ' * # 2 / + 1

/ * / ! 1 -

, 0.

, ! J. Huber (2001) /, % .

% 7 % % 0 %-

. % / ! . 17 -0 2 !

% ' 7 % % % . 0-

. 2 /, 17(3-0 ! ' ! - % 1 / % . / ' ! - +. ( ! ' 0, !, 173- 0 % %

7 % % % . 0. 2 /,

17 -0 % % . 2 * -

/ . % ! %, ' #.

, ! % 1 (Grossman C.J. et al, 1994; Molland J.G. et al., 1990) /, !* -

# ((,-1). ) % 2 -

* 0 (Grossman C.J. et al., 1994; Molland J.G. et al., 1990).

( ! / ' / / %

/ ! % / 1 / % -

' ! 0 %.

, 2 2. ! 0 /, ' - ', % % ' ! 0- % + # !, / %, 2-

, — + # !. - '

' ! . *. 0 % 2 -

! (,-1 # ! ' ., -

/ % # (Huber J., 2001).

% !+ ! ! 1 %-

1 1 /, % 2 2=! !/ '

% # ! / 2 !, *. ! -

, (,-1 (Huber J., 2001).

- % . % 0 ! ! %, /-

% 0 # % 0 !. /- ' 1 / ' 2 *. ! % - # * % % !, ' 7 % %,

193

"9. % !

195

! 1 0 % /. 4 / 7 % % - ' 1 1 !1 ' . ! !* ! -+ ! ! (,-1

!* 2 , * ! ,

# % . (,-1 (Huber J., 2001). ) ' *. % ,

! ! / . ( ! 2 1

' #, / 2- #, 2 % ! -

/ ' ' . 1 -

1 , ' * * / . / 1 ' .

% /. % , % -

% - # '-

% / 2 (,- # * (Huber J., 2001).

2 /, ' , ' .-

! ! ! 2 / . %, !

! * 0 #, 0 #, % . %, CD31, CD4+, CD8+, 1 , 1 . 0 !- 1 / ! ! % #, 2-

, , - / (Aydin Arici et al., 1999; Milson " Nilsson L.A. et al., 1991; Nagy E. et al., 1999; White H.D. et al., 1997).

3 + + % +

-

+ -

.

, 1 0 *# - %-

2 ' !. 2-

/ * *# * , - # ! / (% ! ! ) #. / 0 ! # ! , / - , + !,

! ! "! /" ($ ". ., 1998;

7. ., $ A.M., 1999; Hadden J.W., 1992; Hadden J.W. et al, 1992).

/ (Rutanen E.-M., 1997), ' / !

! 2 1, 1 * 1 % ( . 6), * ! , %

!

-! @ !

 

 

 

 

46. 1/ 2 '%, % * %

1 / % !# (Rutanen E.-M., 1997)

194

-! % % !

# * / - # (Hadden J.W., 1992; Hadden J.W. et al., 1992).

/ + ! # ! / 1 # ( 0) #- 1 1 % 1, . * / ! /-

# 1 % (" -'") .

2 /, % *. ' 2 %-

' % 2=! ! -

%, ! ! ! + / 2 -

% (Grossman C.J. et al., 1994; Deborah J. Anderson, 2000).

( / / ! 2=! !* ! ,

+ . + ! ! / ! '- ! 1 % ! # *. 1 ,7-1 ,

,7-2 (Kincade P.W. et al, 2000).

! *# ! ! '

! ' *. (Hadden J.W., 1992; Hadden J.W. et al., 1992), ' ! -! # ! #

, * ! ' # ,7-2 + # -

1 1 # (,7-1 , ,7-6, )) #,

2 *. 1 % (,7-4, ,7-5).

!

 

2 /, ' , * / ! -

# % !, / (-

# # / , % 2 / * - 1 % 1 !, !/ 1 /, * ! -

/, / / 2 ! (Grossman C.J. et al,

1994; Deborah J. Anderson, 2000; Hadden J.W., 1992; Hadden J.W. et al., 1992).

0 / / / !

# 1 (/ 1) -

! ! / ', 2, ' , / ! 1

! ! ! / + 1 ! .

! ! 1 1 % / / !

/ ' ! ! ! /-

1 % 1 + ' . / 2- ! 1 / !, ' % ! ! 0 1 !1 - / ! / % , / ' / !

1 # 2, # # *,

/ — 2 1 , /, - ', 1 !.

) ! / / ! ! 1 1 %

2 1 % ! / / ! 2- * # / + % + ! 2 - ! % 1 + 2 * # -

# / 1 .

195

" 9. % !

197

) !* *. ! %-

* &", 0 %, # / / 2 !. , % !+-

! ' ! 0 % / 1, 1 &", # ,

% - -

/ 2 ! (Da Silva J.A., Hall G.M., 1992; George and Spector T.D.,

1996; Michael D., Lockshin M.D., 1995; Skogh ., 1997).

( ' ! / , / *, # 0 -

! ! 0 % ' . (- -

/ 2 !, , -

! ! . (George and Spector T.D., 1996; Skogh ., 1997).

) 1 / 0 % ( 1 #-

), * ! 2 1 2 !

0 + 1 (Da Silva J.A., Hall G.M., 1992; George and Spector T.D., 1996; Skogh ., 1997) -

1 (Roy S.K., Kole A.R., 1997).

2 ' / -

! ! 0 % 1 / 2, 2 1 /- *. 1 ! % + ! ( , -

, / 1 2 .), /

' ! ! ! . % % % (Donald P., McDonnell, 2000). 0 % 2 !/ !

% #, # /-

% %, % * 0 % - # !/ ! + ! 0 %, % %, -

% % * * . , ,

% % 2 ! % %- % # # 2 / % %

, % (%).

2 /, !. 2 # !-

1 1 % * / !* - # / ! 1 ,

/ ! % % % /, ' / ' . (2-

, , ) / / ' 1 /-

% %, ' . % / ! %.

% , 0 !* # 2 / -

! ' . / % - + !, , -

, + % #, 0 / .

196

198

-! % % !

1.$ ". . // 2 ! % !.

— 1998. — A 3. — . 28-34.

2.". . ! % ! % !. — ), 1999. — . 50-57.

3.7. ., $ A.M. // 2. %-

%. — ., 1999. — . 34-41.

4.Alan (. Me Craden and William H. Stimson. Effects of Estrogens/Androgens on the Immune response. Springer-Verlag 1994: 36-43.

5.Albrecht AE, Hartmann BW, Sctoltren C, et al. Effect of estrogen replacement therapy on natural killer cell activity in postmenopausal women. Maturitas 1996; 25/3: 293.

6.Anna Oldenhave, Coen Netelenbos. Pathogenesis of climacteric complaints: ready for the ctauge? 1994; 343: 651-652.

7.Aydin Arici, Harvey I. Kliman, David L. Olive, reproductive immunology and its disorders. Reproductive Endocrinology, Physiology, clinical Management (4"1 Edition) 1999: 345-351.

8.Blum M, Zacharovich D, Pery J, Kitar E. Lowering effect of estrogen replacement treatment on immunoglobulins in menopausal women. Rev. Fr. Gynecol. Obstet 1990; 162, 209-9:56-67.

9.Brunelli R, Frasca D, Perrone G, et al. Hormone replacement therapy affects various immune cell subsets and natural cytotoxity. Gynecol. Obstet. Invest 1996; 88, 128-31: 25-28.

10.Charles J. Grossman, Alan B. Me Cruden and William H. Stimson. Bilateral communication between the endocrine and immune systems. Springer-Verlag 1994: 36-43.

11.Chernyshov VP, Radysh TV, Gura IV, et al. Immune disorders in Women with premature ovarian failure in initial period. Am. J. of Reprod. Immunology 2001; 46: 220-225.

12.Da Silva JA, Hall GM. The effects of gender and sex hormones on outcome in rheumotoid arthritis. Baillieres Clen. Rteumathol 1992; 6,196-219: 18-25.

13.Deborah J.Anderson. Immunologic aspects of menopause. Menopause. Biology and Pathology / Ed by Rogerso A. Lobo, Jennifer Kelsey, Robert Marcus 2000: 353-356.

14.Donald P, McDonnell. Molecular Ptharmacology of Estrogen and Progesterone Receptors. Menopause Biology and Pathology / Ed by Rogerio A. Lobo. San DiegoTokyo 2000: 459-480.

15.Drackmann R.. Review: Female sex hormones, autoimmune diseases and immune response. Gynecol. Endocrinol 2001; 15, 6: 69-76.

16.George and Spector T.D. Arthritis, menopause and estrogen. Progress in the Management of the Menopause / Ed by Barry G.Wren. Sydney 1996: 323-327.

17.Hadden JW. Thymic endocrinology. Int. J. Immunopharmacol 1992; 3, 345-52: 27-31.

18.Hadden JW, Malec PH, Colo J, Yaddtn EM. Thymic involution in aging. Prospects for correctin. Ann Y Acad. Sci 1992; 3, 231-9: 26-31.

19.Huber J. Gruber. Immunological and dermatological impact of progesterone. Gynecol. Endocrinol 2001; 15,6: 18-21.

20.Kincade PW, Medina KL, Payne KJ, et al. Estrogen rehulates lymphopoesis. The Menopause at the Millennium 2000: 171-174.

21.Lemola—Virtanen R, Helemins H, Saine M. Hormone replacement therapy and some salivary antimicrobial factors in post and perimenopausal womtn. Maturitas 1997; 50, 145-51: 54-61.

197

" 9. % !

199

22.Michael D, Lockshin MD. Hormone replacement therapy trombosis and rheumatic disease // Clinical Journ. Of women's health.- 1995.-Vol.2, 1.- P.40-44.

23.Michelle P. Warren et al. Alternative therapies to hormone replacement therapy. Menopause Biology and Pathology / Ed by Rogerio A. Lobo. San Diego-Tokyo 2000: 459-480.

24.Milson " Nilsson LA, Brandberg A, Ekelund P, et al. Vaginal immunoglobulin A (Ig

A)levels in post-menopausal women: influence of oestriol therapy. Maturitas 1991; 52, 129-35: 56-62.

25.Molland JG, Barraclough BH, Gebski V, et al. Susceptibility of postmenopausal women to infection with HIV during vaginal intercourse (letter). Med. J. Aust 1990; 60, 299: 24-37.

26.Nagy E, Baral E, Berczi I. Immune System Estrogens and Antiestrogens I / Ed by Oettel M, Schillenger E. 1999: 343-349.

27.Roy SK, Kole AR. Autommune precocious menopause: therapeutic conseouences. Contracept. Fertil. Sex 1997; 50, 639-42: 61-68.

28.Rutanen E.-M. Biology of the endometrium. Progress in the Management of the Menopause / Ed by Barry G. Wren. New York-London 1997: 217-225.

29.Skogh T. Estrogen and rheumatic disease. The Climacteric and its treatment / Ed by Nils-Otto Sjobergaud). New York 1997: 33-37.

30.White HD, Crassi KM, Givan AL, et al. CD3+, CD8+, CTL-activity nithin the human female reproductine tract: influence of stage of the menstrnal cycle and menopause. J. Immunolog 1997; 158: 3017-3027.

10

,43), :9 ") 3) & , , ")4 ) 7> :3 4 ?3 ,

43 4) ,( )9 , 3 : 53 ;, :

. ., $ &. ., -. .

;, )(, ' / — / ' + 1 % 0

, / *. / ! * - # *.

! %-% /-! % .-

' / (;5), , # ! . ' / '-

. % % (' / /-

, % , 0 2, +

2, % 0 % ! ! / -

2 % 0) — % ! !* ! / - 2 / 2 1 / 1 #.

( ! 2 ! 2

% . ' /. , -

+ % 2 1074 ' . %-

+ ! % ! ;5 2 ! 789 (63,68%) #, 269 (21,71%) — /

198

, 0 26 (2,42%) / 1 ' *. ( 1

1 1 2 * , ' 2

! # ! % % / / * 2 - / # % # 2 / # 1 ! 0- % / 1 1 ' ..

! # %, %,

# 1 / !/ %-% /-

. ! ' / %-% /-! 2 2

2 # 1 # * 2= 2-

! # % . ' /, + !

2 1 1 # *. 1 ! /.

199

+10. % / %+ !...

201

2-", 2-"

2 , /-

! # / !/ 0 1 . !- ». 2 + , 2 *. 1 2 / & + . . ., 1996; '., X., 1989; Inzucchi

ilvio E., Burrow Gerald N., 1999; Takano . et al, 1985; Yen S.S.C., Jaffe Robert (., 999), 7 " * " %-\

7 " %

1*. , -

, 2 / ' / 0 %)

+ !*. ' ' . / ! / % 1 %).

2 /, # ! % ! -

% % / (* / *., - *. %, , %), , * -

, 1 ! ! %- 1 / *. ! (! -. ., 1994). ) 1 / 0 1 / !/ % ! ; !* 2 2= - ix 1 . 6 ! % - 0 ! /, #, + !, -

/ 2 !, ' #

+-% / % + * 2 /

1, 1 1 % (! -. ., 1994). ,/, 2 / 2 % /-

!* * % / % 2, -

2 % / * !* * - : % / 2 (7). 3% 1 0 /

( ), ' ' 2 ! /-

( , .). , '-

7 ! + % — # /

: ( '., X., 1989; Inzucchi Silvio E., Burrow

erald N.. 1999; Yen S.S.C., Jaffe Robert (., 1999).

% % / 1 , *. 1 % "), 7 % # *. ", * , .- »* ' / / # * %: ( 4)

( 3). & 1 / #

) !/ !* % % / ( . 1).

, 1 # # !1 % 2 *, / 1 — -

# * " 2 ' 7 % ( - : '., X., 1989; . . ., 1995; Inzucchi

Silvio , Burrow Gerald N.. 1999; Takano . et al, 1985).

0 , % -

.1 / ! # # 3 + , %- 1/ ( ., 1999).

200