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目的研究子宫肌瘤患者雌激素受体（ＥＲ）的改变及其性激素调节。方法应用放射配体结合法和免疫组化法测定子宫肌瘤患者的外周血白细胞和子宫组织中的ＥＲ，同时放免测定血清中性激素的含量。结果子宫肌瘤患者的雌激素和孕激素（Ｅ和Ｐ）水平与对照组相差不显著（Ｐ＞０．０５），而其白细胞ＥＲ水平在围排卵期和黄体期高于对照组（Ｐ＜０．０５），子宫组织中ＥＲ与白细胞ＥＲ呈正相关（Ｒ＝０．９８２，Ｐ＜０．０１），不同数目和大小的子宫肌瘤，其白细胞ＥＲ相差不显著（Ｐ＞０．０５）。白细胞和子宫组织中ＥＲ水平与Ｅ２正相关，与Ｐ负相关（Ｐ＜０．０５）。结论白细胞ＥＲ与子宫组织中ＥＲ是同源的，受相同的遗传基因控制，也受相同的机制（Ｅ和Ｐ）进行调节，测定白细胞ＥＲ可以反映子宫组织中ＥＲ水平。子宫肌瘤的发生并非由Ｅ２的直接升高引起，而可能与ＥＲ的升高有关，ＥＲ加强和放大了Ｅ２的生物效应，长期刺激诱发肌瘤发生。
Objective To study the changes of estrogen receptor (ER) and the regulation of sex hormones in patients with uterine fibroids. Methods Radioligand binding assay and immunohistochemistry were used to determine ER in peripheral blood leucocytes and uterine tissues of patients with uterine leiomyoma and serum levels of sex hormones were determined by radioimmunoassay. Results The levels of estrogen and progesterone (E and P) in uterine fibroids patients were not significantly different from those in control group (P> 0.05), while the levels of leukocyte ER were higher in ovulation period and luteal phase than those in control group (P < 0.05). There was a positive correlation between ER and leukocyte ER in uterine tissue (R = 0.982, P <0.01). There was no significant difference in the leucocyte ER between different numbers and sizes of uterine fibroids (P> 0.05) . ER levels in leukocytes and uterus were positively correlated with E2 and negatively correlated with P (P <0.05). Conclusions The leukocyte ER is homologous to ER in uterine tissue and is controlled by the same gene. It is also regulated by the same mechanism (E and P). The determination of leukocyte ER can reflect the level of ER in uterine tissue. The occurrence of uterine fibroids is not caused by the direct escalation of E2, but may be related to the increase of ER, ER strengthen and enlarge the biological effects of E2, long-term stimulation of fibroids.