放置宫内节育器对子宫内膜血管内皮生长因子及其激酶受体表达及微血管密度变化的影响

Effects of intrauterine contraceptive device on expression of vascular endothelial growth factor, kinase insert domain-cont aining receptor and microvessel density in endometrium

目的 探讨放置固定式带铜宫内节育器 (FCu IUD)和含吲哚美辛FCu IUD(FICu IUD) ,对子宫内膜组织中血管内皮生长因子 (VEGF)及其激酶受体 (KDR)表达以及微血管密度(MVD)变化的影响及意义。方法 采用免疫组化法及原位杂交法 ,检测放置FCu IUD妇女 (10例 ,FCu IUD组 )及放置FICu IUD妇女 (10例 ,FICu IUD组 )放置IUD前后子宫内膜VEGF、VEGFmRNA及KDR的表达 ,并计数子宫内膜MVD。结果 FCu IUD组放置IUD后 ,VEGF及KDR蛋白为 0 5 6 8± 0 0 2 7,0 2 4 4± 0 0 2 2 ,均高于放置IUD前的 0 35 7± 0 0 32 ,0 2 15± 0 0 2 9,放置IUD前后比较 ,差异有显著性 (P <0 0 5 )。FCu IUD组放置IUD前VEGFmRNA表达为 0 35 9± 0 0 2 2 ,低于放置IUD后的 0 4 2 5± 0 0 19,放置IUD前后比较 ,差异有显著性 (P <0 0 5 )。FICu IUD组放置IUD前后VEGF、KDR蛋白及VEGFmRNA表达比较 ,差异无显著性 (P >0 0 5 )。FCu IUD组放置IUD后MVD为 19 8± 4 8,明显高于放置IUD前的 15 4± 2 8,且与VEGF蛋白的表达呈正相关关系 (r=0 84 7,P <0 0 1)。FICu IUD组放置IUD前后MVD比较 ,差异无明显性 (P >0 0 5 )。结论 放置FCu IUD可促进子宫内膜VEGF及KDR的表达 ,FICu IUD可抑制子宫内膜VEGF及KDR的生成。VEGF及KDR可?

Objective To investigate the expression of vascular endothelial growth factor (VEGF) and its receptor, kinase insert domain-containing receptor(KDR) and microvessel den sity(MVD) in endometrium from women wearing fixed copper-intrauterine contracep tive device(IUD,FCu-IUD) or fixed indomethacin-releasing copper-IUD(FICu- IUD). Methods Twenty healthy women were divided into two study groups: 10 cases wearing the FC u-IUD(FCu-IUD group), 10 cases wearing the FICu-IUD(FICu-IUD group). Immuno histochemical technique was used to determine the expression of VEGF and KDR in endometrium,and the microvessel density (MVD) was counted. The expression of V EGF mRNA was determined by in situ-hybridization. Results Before insertion of FCu-IUD,the expression of VEGF and KDR proteins was 0.35 7±0.032 and 0.215±0.029 respectively. After insertion of FCu-IUD, the e xpression of VEGF and KDR proteins was 0.568±0.027 and 0.244±0.022 respec tively, significantly higher than before insertion (P<0.05).The expressio n of VEGF mRNA was 0.359±0.022 before insertion of FCu-IUD, after insertion of FCu-IUD, the expression of VEGF mRNA was 0.425±0.019(P< 0.05).Th ere were no significant changes in the level of VEGF protein and mRNA, as well a s KDR in endometrium before and after insertion of FICu-IUD. Compared with bef ore insertion of FCu-IUD 15.4±2.8, a significant increase in MVD was observe d after insertion of FCu-IUD 19.8±4.8, and the expression of VEGF protein wa s positively correlated with MVD(r=0.847,P<0.01). MVD counts were n ot different significantly before and after insertion of FICu-IUD. Conclusions FCu-IUD can enhance the expression of VEGF a nd KDR in the endometrium. FICu-IUD can inhibit the activity of VEGF and KDR b y releasing indomethacin. VEGF and KDR may be related to the structural and fun ctional changes of microvessels in endometrium after insertion of FCu-IUD or F ICu-IUD.