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目的 探讨子宫肌瘤在注入氨甲喋呤 (MTX)后缩小的机制。方法 对 5例子宫肌瘤在注入MTX 2周及 1个月后行手术治疗 ,对其标本进行光镜和电镜观察 ,并与同期未注药标本进行比较。结果 所有注入MTX的标本光镜下 ,均可见明显的平滑肌细胞的水肿、变性。电镜下见平滑肌细胞内变性、水肿 ,扩张的内质网和线粒体等。结论 MTX的缩瘤效果是通过减少肌瘤内的血供和直接的细胞凋亡来完成的。
Objective To investigate the mechanism of uterine fibroids shrinking after injection of methotrexate (MTX). Methods Five cases of uterine leiomyoma were surgically treated for 2 weeks and 1 month after injection of MTX. The specimens were observed under light and electron microscopes and compared with those without injection. Results All specimens injected with MTX under light microscope showed obvious edema and degeneration of smooth muscle cells. Electron microscope, see the smooth muscle cell degeneration, edema, expansion of the endoplasmic reticulum and mitochondria. Conclusions The tumor-suppressive effect of MTX is achieved by reducing blood supply and direct apoptosis in fibroids.