摘要
目的：探讨多囊卵巢综合征（polycystic ovary syndrome,PCOS）患者早期流产与其子宫内膜上雌孕激素受体的关系,旨在找出原因,对症治疗。方法：选择PCOS不孕患者32例为实验组（其中12例有早期自然流产史）,同期输卵管性不孕患者20例为对照组,观察组患者于月经干净3-7d时、或闭经期、或淋漓出血时,对照组患者于月经干净3d至排卵前在宫腔镜下取得子宫内膜标本,行病理学检查及免疫组织化学实验,测定雌激素受体（estrogen receptors,ER）和孕激素受体（progesterone receptors,PR）在子宫内膜腺体和间质细胞的细胞核内的表达。结果：ER在腺体和间质中表达的免疫组织化学积分PCOS组较输卵管性不孕组均明显减少（P=0.004,P=0.001）。PR在腺体和间质中表达的免疫组织化学积分PCOS组较输卵管性不孕组均明显减少（P=0.02,P=0.004）。PCOS组腺体细胞和间质细胞ER和PR的表达在增生早、中、晚期组的免疫组织化学积分3三组间差异均无统计学意义（均P〉0.05）。PCOS患者流产组的子宫内膜腺体中表达的免疫组织化学积分较非流产组明显减少（P=0.02）;在间质中,流产组与非流产组间无统计学差异（P=0.32）。PCOS患者中的流产组和非流产组PR在子宫内膜腺体和间质中表达的免疫组织化学积分均无统计学差异（均P〉0.05）。结论：PCOS患者子宫内膜雌、孕激素受体含量减少可能是其自然流产的重要原因;PCOS患者的雌、孕激素受体缺乏周期性改变,可使胚胎着床障碍或流产。
Objective To explore the relationship between the spontaneous abortion and changes of estrogen receptors（ER）and progesterone receptors（PR）in the endometria of patients with polycystic ovary syndrome（PCOS）.Methods Thirty-two patients who suffered PCOS combined with infertilitas feminis were enrolled in a experimental group,and 20 patients with tubal infertilitas feminis having the corresponding time period as a control group.The expressions of ER and PR in the endometria were observed by pathological examination and immunohistochemical staining.Results The expressions of ER and PR in the glands and interstitium of endometrial in the PCOS group were significantly lower than those of the tubal infertilitas feminis group（P=0.004,P=0.001）.The expressions of ER and PR in the PCOS group in the glands organ and interstitium of endometrial among 3 different periods were not significantly different（P〉0.05）.The expressions of ER in the glands of endometrium in the spontaneous abortion group were significantly lower than those of the non-spontaneous abortion group（P=0.02）,but there was no statistical difference between the two groups in the interstitium of endometria（P〉0.05）.The expression of PR in the glands interstitium of endometria showed no statistical difference between the spontaneous abortion group and the non-spontaneous abortion group（P〉0.05）.Conclusion The decrease of ER and PR of endometrial in the PCOS patients,may be a reason for spontaneous abortion,and the cyclical irregularity of ER and PR in the PCOS patients is another cause of spontaneous abortion.
出处
《中南大学学报（医学版）》
CAS
CSCD
北大核心
2008年第6期518-522,共5页
Journal of Central South University ：Medical Science
基金
湖南省卫生厅科研基金课题(C2005017)~~
关键词
多囊卵巢综合征
自然流产
雌激素受体
孕激素受体
polycystic ovary syndrome
spontaneous abortion
estrogen receptor
progesterone receptor
