Kachajlo I. Prognostic criteria for assessment of the state of women in the perimenopausal period and their management at endometrium pathology

The work deals with investigation of the prognostic criteria for asessment of the state of perimenopausal women and their management at endometrium pathology. Clinical peculiarities of menstrual function disorders in 149 women with menometrorragia and metrorragia were studied. The amount of insulin, cortisole and leptin was investigated in perimenopausal women vs. the controls and women whose menopause was complicated by hyperplastic processes of the endometrium, metabolic disorders and their combination. An important role of apoptosis markers (sFas,Fas-ligand,TNF-a) in the blood serum was proven. The changes and proliferative potential of protein Кі-67 and р16ІNK4a were evaluated at analysis of lipoprotein blood spectrum, pathomorphological and immunohistochemical investigation of endometrium іскфзштпі of the women with different types of hyperplasia. The obtained findings allowed to analyze the character of negative influence of metabolic disorders on the proliferative potential and the risk of its neoplastic transformation. Pathogenetically subsantiated technique of management of perimenopausal women with endometrium pathology or metabolic disorders were analyzed. Its efficacy when compared with the traditional methods of therapy was proven.