多囊卵巢综合征患者子宫内膜病理改变及雌、孕激素受体测定

Pathological and Immunohistochemical Study on Estrogen and Progesterone Receptors in Endometrium of Polycystic Ovarian Syndrome

目的观察多囊卵巢卵巢综合征（ＰＣＯＳ）患者子宫内膜病理改变及雌激素受体（ＥＲ）、孕激素受体（ＰＲ）改变。方法对３９例ＰＣＯＳ患者进行子宫内膜病理检查，采用免疫组化方法测定子宫内膜ＥＲ及ＰＲ，并以正常妇女作为对照。结果３４例（８７．２％）ＰＣＯＳ患者子宫内膜呈无排卵型，内膜增殖症发生率为５１．３％（２０／３９），内膜腺体发育不同步为３５．９％（１４／３９），内膜间质反应不良为４６．２％（１８／３９）。ＰＣＯＳ患者子宫内膜增殖期ＥＲ、ＰＲ较正常妇女增多（Ｐ＜０．０５），内膜增殖症者间质ＰＲ减少（Ｐ＜０．０５）且分布不均匀。结论ＰＣＯＳ患者子宫内膜的病理改变和局部ＥＲ、ＰＲ减少或缺乏，可能是不孕的原因之一。

Objective To investigate the changes of endometrium in infertility patients with polycystic ovarian syndrome (PCOS). Methods The endometrium from 39 patients with PCOS were studied by HE stain and immunohistochemical method using anti estrogen receptor(ER) and anti progesterone receptor(PR) monoclonal antibodies Results 87.2% (34/39) of the endometrium showed anovulatory proliferative phases; 51.3% (20/39) had signs of hyperplasia; 35.9% (14/39) showed asynchronization of endometrial glands and 46.2% (18/39) poor response of stroma to sex hormone. The levels of ER and PR in endometrium during proliferative phase were significantly higher than those of normal control, and the PR in the stroma of hyperplasia endometrium had an uneven distribution and was significantly less than that in the control group ( P <0.05). Conculsions The endometrial histo pathological changes and local decrease or absence of ER and PR in PCOS might be one of the causal factors of infertility.