Ⅳ型胶原和层黏连蛋白与不孕症的关系

Relations of collagen type Ⅳ and laminin expression with infertility

目的 :探讨女性不孕症在着床方面的缺陷 ,尤其是子宫内膜接受性的异常。方法 :采用免疫组织化学方法检测 4 1例生育组、 4 3例原因不明不孕组妇女细胞外基质 型胶原 (COL )、层黏连蛋白 (L N)在分泌期子宫内膜中的表达。结果 :COL 、L N在生育组分泌中期子宫内膜中呈强表达 ,早期次之 ,晚期较弱 ;不孕组分泌各期表达均高于生育组 ,COL 、L N在分泌期子宫内膜上的表达在生育组与不孕组间不同 ,在同一组子宫内膜腺上皮细胞及基底膜 ,血管内皮细胞及基底膜和间质细胞上表达不同。结论 :COL 、L N在分泌期子宫内膜上呈周期特征性变化 ,并参与子宫内膜的功能变化及胚泡的着床环节。其过高表达影响胚泡对母体子宫内膜的识别、定位黏着过程 ,导致胚泡着床失败。

Objective To investigate the defect in embedding of female inferitility, especially the abnormity of the endometrium acceptance. Methods Immunohistochemical method was used to test the expressions of extra cellar matrix proteins-collagen type Ⅳ (COLⅣ) and laminin (LN) on the secretory phase endometrium of 41 fertile women (fertility group)and 43 unexplained infertile women (infertility group).Results The expressions of COLⅣ and LN in fertility group were strong in early secretory phase, while their expressions were the strongest in mid-term secretory phase and the weakest in late secretory phase. The expressions of COLⅣ and LN in every secretory phase in the infertility group were stronger than that in the fertility group, the expressions of COLⅣ and LN in the secertory phase endometrium in the fertility group was different from that in the infertility group. The expressions of COLⅣ and LN in gland-epithelia of the endometrium and the basemembrance, the blood vessel endothelial basemembrance and the interstitial cells in the same group were different. Conclusion The COLⅣ and LN expressions in the secertory phase change periodically and participate in the function change of the endometrium and the embedding of the blastocyst. Their stronger expressions affect the identification,location, and adherence to the endometrium of marix,and lead to the failure of the blastocyst embedding.