子宮內膜異位 | Endometriosis

子宮內膜異位

子宮內膜異位症是一種雌激素依賴性疾病,子宮內膜組織在子宮外形成病變。據估計,10%的育齡婦女受到子宮內膜異位症的影響,不孕症和/或疼痛患者的子宮內膜異位症發病率上升到30%至50%,對她們的身體、精神和社會福利產生重大影響。現時還沒有已知的治療方法,而且由於其副作用,大多數現時的醫療方法不適合長期使用。子宮內膜異位症在美國的年費用估計為188億至220億美元(2002年的數位)。雖然子宮內膜異位症是100多年前首次被描述的,但現時對其發病機制、自發演變以及與不孕症和盆腔疼痛相關的病理生理學的認識仍不清楚。在第十届子宮內膜異位症世界大會之後召開了一次協商一致的研討會,以確定子宮內膜異位症研究優先事項的建議。影響子宮內膜異位症研究能力的一個主要問題是需要多學科的專門知識。共提出了25項研究建議,分為5個小標題:(a)診斷,(b)分類和預後,(c)治療和結果,(d)流行病學和(e)病理生理學。子宮內膜異位症的研究是資金不足相對其他疾病與高醫療負擔。這可能是由於對一種只影響婦女的複雜而缺乏瞭解的疾病製定競爭性研究建議的實際困難。通過發表這一國際研究優先事項共識聲明,研討會參與者希望鼓勵研究人員製定新的跨學科研究建議,吸引更多資金支持子宮內膜異位症的研究。

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Endometriosis

Endometriosis is an estrogen-dependent disorder where endometrial tissue forms lesions outside the uterus. Endometriosis affects an estimated 10% of women in the reproductive-age group, rising to 30% to 50% in patients with infertility and/or pain, with significant impact on their physical, mental, and social well-being. There is no known cure, and most current medical treatments are not suitable long term due to their side-effect profiles. Endometriosis has an estimated annual cost in the United States of $18.8 to $22 billion (2002 figures). Although endometriosis was first described more than 100 years ago, current knowledge of its pathogenesis, spontaneous evolution, and the pathophysiology of the related infertility and pelvic pain, remain unclear. A consensus workshop was convened following the 10th World Congress on Endometriosis to establish recommendations for priorities in endometriosis research. One major issue identified as impacting on the capacity to undertake endometriosis research is the need for multidisciplinary expertise. A total of 25 recommendations for research have been developed, grouped under 5 subheadings: (a) diagnosis, (b) classification and prognosis, (c) treatment and outcome, (d) epidemiology, and (e) pathophysiology. Endometriosis research is underfunded relative to other diseases with high health care burdens. This may be due to the practical difficulties of developing competitive research proposals on a complex and poorly understood disease, which affects only women. By producing this consensus international research priorities statement it is the hope of the workshop participants that researchers will be encouraged to develop new interdisciplinary research proposals that will attract increased funding support for work on endometriosis.(1)

Refs:

  1. Peter A. W. Rogers, BSc, PhD, Thomas M. D’Hooghe, MD, PhD, Asgerally Fazleabas, PhD, Caroline E. Gargett, PhD, Linda C. Giudice, MD, PhD, MSc, Grant W. Montgomery, PhD, Luk Rombauts, MD, PhD, Lois A. Salamonsen, PhD, and Krina T. Zondervan, DPhil. Priorities for Endometriosis Research. Reprod Sci. 2009 Apr; 16(4): 335–346. doi: 10.1177/1933719108330568. PMCID: PMC3682634. PMID: 19196878