МЕХАНИЗМЫ ВТОРИЧНОЙ НЕДОСТАТОЧНОСТИ ЯИЧНИКОВ ПРИ ОПЕРАЦИЯХНА ОРГАНАХ МАЛОГО ТАЗА (ЭКСПЕРИМЕНТАЛЬНОЕ ИССЛЕДОВАНИЕ)

Цель работы - установить роль гистерэктомии в формировании вторичной недостаточности яичников и оценить возможность применения DHEA. Материалы и методы. Половозрелые крысы-самки аутбредного стока Вистар. Основная группа: 1а - гистерэктомия + сальпингэктомия (n=24), Iб - гистерэктомия (n=6), Iв - сальпингэктомия (n=6). Группа сравнения - гистерэктомия + сальпингэктомия + DHEA в течение четырех недель после операции (n=12). Интактный контроль (n=12). Иммуноферментный анализ сывороточных концентраций антимюллерова (АМГ) и фолликулостимулирующего (ФСГ) гормонов, тестостерона (Т). Результаты. Установлено статистически значимое снижение АМГ после гистерэктомии и сальпингэктомии во все сроки опыта (2-10-30-40-е сут.), повышение ФСГ только к 40-м сут., снижение Т - только на 10-е сутки опыта по сравнению с контролем. Гистерэктомия значимо не изменяет концентрации АМГ, ФСГ и Т на 10-е сутки. Сальпингэктомия значимо снижает концентрации АМГ и Т и не влияет на ФСГ. Применение DHEA в дозе 1 мг/сут. в течение 28 дней не изменяет концентрации ФСГ и Т, значимо увеличивает АМГ по сравнению с таковым у животных после операции, но остается значимо ниже такового в контроле. Заключение. Изолированная гистерэктомия существенно не влияет на функциональный овариальный резерв. Изолированная сальпингэктомия, а также комбинированный объем операции (гистерэктомия + сальпингэктомия) приводят к вторичной недостаточности яичников. Эффект DHEA на функцию гонад остается сомнительным.

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