PCOS患者分泌期子宫内膜AngⅡ及AT2的表达变化

Expression of AngⅡ and AT2 in endometrium of patients with PCOS at secretory phases

目的观察血管紧张素Ⅱ（AngⅡ）及其2型受体（AT2）在多囊卵巢综合征（PCOS）患者分泌期子宫内膜中的表达变化。方法12例曾接受促排卵治疗、基础体温双相的PCOS患者为A组，其中6例行诊断性刮宫（诊刮）术者为B组；10例月经正常的育龄妇女作为对照（C组）。于经前2～3d测血清生殖激素及子宫动脉和子宫内膜螺旋动脉的收缩期峰值流速（Vs）、舒张期末血流速度（WD）、阻力指数（RI）。同日B、C组行诊刮术，测子宫内膜AngⅡ及AT2。结果B组子宫内膜腺上皮AngⅡ灰度值低于C组，（P〈0．01），其孕酮（P）显著低于C组（P〈0．01），腺上皮AngⅡ与P呈正相关（r=0．969，P〈0．05），其子宫内膜螺旋动脉管周基质细胞AngⅡ与螺旋动脉RⅡ呈正相关（r=0．989，P〈0．05）。A组子宫内膜螺旋动脉显示率低于C组（P〈0．05）。C组螺旋动脉Vs与其管周基质细胞AT2呈正相关（r=0．731，P〈0．05）。结论PCOS患者经促排卵治疗后，分泌期子宫内膜腺上皮细胞AngⅡ的表达高于正常，可能与P较低有关；分泌期子宫内膜血供较少，与螺旋动脉管周基质细胞AngⅡ及AT2的表达有关。

[Objective] To detect the expression of angiotensin Ⅱ （Ang Ⅱ ） and it＇s type-2 receptor（AT2） in the endometrium at the secretory phases of patients with polycystic ovary syndrome（PCOS）. [Methods] 12 cases with PCOS who showed hiphasic basal body temperature（BBT） after being given clomiphene citrate （CC） were chosen as group A,in which 6 cases were curettaged as group B. 10 normal women of reproductiv.e age were as group C. Serum sex hormones was assayed 2- 3days before menstruation. At the same day,the peak systolic velocity（Vs） ,end-diastolic velocity（VD） and resistance index（RI） were measured. The curettage was performed in group B and group C,the Ang Ⅱ and AT2 was investigated. [Results] The Ang Ⅱ at the glandular epithelia cells in group B was lower than that of group C（ P 〈 0. 01）. Progesterone（P） of group B was significantly lower than that of group C（ P 〈 0. 01）. There was a positive correlation between P and Ang Ⅱ in the glandular epithelia cells in group B （r =0. 969, P 〈0. 05）. In group B,positive correlation was found between the Ang Ⅱ in perivascular stromal of spiral arteries and RI of spiral arteries （ r =0. 989,P 〈 0. 05）. The rate of uterine spiral artery blood flow displaying in group A was lower than that in group C（ P 〈 0. 05）. In group C,positive correlation was found between value of AT2 in perivascular stromal of spiral arteries and Vs of spiral arteries （ r = 0. 731, P 〈 0. 05）. [Conclusions] P was lower in PCOS at the secretory phases after being given CC, which may lead to the higher expression of Ang Ⅱ in the glandular epithelia cells. The expression of Ang Ⅱ and AT2 in the endometrium may be involved in the insufficient blood flow of endometrium during the secretory phases of PCOS.