ФИЗИОЛОГИЧЕСКИЕ АСПЕКТЫ ПРИМЕНЕНИЯ АНАЛОГОВ ГОНАДОТРОПИН-РИЛИЗИНГ-ГОРМОНА В АКУШЕРСКО-ГИНЕКОЛОГИЧЕСКОЙ КЛИНИКЕ И ЭКСПЕРИМЕНТЕ
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Ключевые слова

агонисты гонадотропин-рилизинг-гормона
яичники
матка
фолликулы
репродукция
пролиферация
дифференцировка

Как цитировать

Майбородин, И. В., Пичигина, А. К., Майбородина , В. И., & Лушникова , Е. Л. (2022). ФИЗИОЛОГИЧЕСКИЕ АСПЕКТЫ ПРИМЕНЕНИЯ АНАЛОГОВ ГОНАДОТРОПИН-РИЛИЗИНГ-ГОРМОНА В АКУШЕРСКО-ГИНЕКОЛОГИЧЕСКОЙ КЛИНИКЕ И ЭКСПЕРИМЕНТЕ. Российский физиологический журнал им. И. М. Сеченова, 108(11), 1393–1409. https://doi.org/10.31857/S0869813922110061

Аннотация

Проведен поиск литературы для изучения работ, посвященных результатам применения агонистов гонадотропин-рилизинг-гормона (ГнРГ) в акушерско-гинекологической клинике и эксперименте. Рассмотрены физиологические аспекты влияния ГнРГ на яичники и матку как в норме, так и при некоторых патологических состояниях. Сделано заключение, что агонисты ГнРГ при длительном применении подавляют овуляцию и вызывают состояние, сходное с менопаузой. Инфузия агониста ГнРГ является простым методом подавления продукции лютеинизирующего и фолликулостимулирующего гормонов, а также развития фолликулов. При этом в яичниках подавляется функциональная активность гранулезных клеток через супрессию синтеза ДНК и индукцию апоптоза с одновременной стимуляцией дифференцировки клеток в преовуляторных фолликулах. Такое состояние является обратимым, сохраняется фертильность. За счет быстрой инволюции матки после применения аналогов ГнРГ возможны задержка или даже остановка прогрессирования миомы с исчезновением ее симптомов. На фоне гипотрофии матки эндометрий соответствует атрофическому или покоящемуся пролиферативному типу. Вместе с этим есть прямо противоположные данные о том, что длительное использование ГнРГ способствует гиперплазии эндометрия и эндометриту. Препараты ГнРГ успешно применяют для лечения доброкачественных и онкологических процессов в яичниках и матке, а также для воздействия на метастазы. Но существуют и исследования, показывающие, что прямой эффект ГнРГ на опухоли мало выражен. Высказываются опасения, что гонадотропины могут даже стимулировать развитие рака яичников, воздействуя на определенные рецепторы. Большинство ученых сообщает о хорошей протективной способности агонистов ГнРГ в условиях химиотерапии, но также имеются данные о слабой эффективности или вообще отсутствии защитного действия препаратов данной группы. В любом случае противоречивость публикаций по каждому из аспектов эффекта ГнРГ свидетельствует о его малой изученности, целесообразности продолжения не только прикладных, но и фундаментальных исследований.

https://doi.org/10.31857/S0869813922110061
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