着床窗期宫腔镜下子宫内膜形态与性激素及其受体表达的研究

Study on the Hysteroscopic Endometrial Appearances and the Expression of Sex-Hormone Receptor at the Implantation Window

目的:探讨着床窗期宫腔镜下子宫内膜形态与性激素及其受体表达的关系。方法:对55例不孕患者及16例正常生育者在排卵后7～9天,行宫腔镜子宫内膜形态的检查,并检测血雌二醇、孕酮及内膜雌激素受体(ER)、孕激素受体(PR)。结果:不孕组宫腔镜下子宫内膜血管及腺体发育较对照组差,差异有统计学意义(P<0.05)。内膜差组腺上皮细胞ER表达较内膜佳组弱,差异有统计学意义(P<0.05);内膜差组间质PR表达较内膜佳组弱,差异有统计学意义(P<0.05)。结论:不孕患者子宫内膜ER、PR的低表达,可能是导致子宫内膜腺体和血管网发育不良的重要原因之一。通过宫腔镜观察子宫内膜腺体和血管形态是一种较好的、简单可行的评估子宫内膜容受性的方法。

Objective：To explore the relation between the hysteroscopic endornetrial appearance and the expression of sex-hormone receptor at the implantation window. Methods：55 infertile women and 16 fertile women underwent hysteroscopy at the implantation window, and meanwhile the levels of estradiol （ E2）/progesterone（P） in the serum and the expression of estrogen receptor （ER） / progesterone receptors （PR） in the endometrium were examined. Results：There was significant difference between the infertile women with the fertile women in the gland opening and the capillary vessel of endometrium under hysteroscopy, which the former gland opening was little and capillary vessel was poor. Compared with the good endometrial group, the poor endometrial group expressed significantly lower levels of ER in the epithelial cells （ P〈 0.05）, and also lower levels of PR in the stromal cells （ P〈 0.05） . Conclusions： The decreased expression of ER and PR in endometrium of the infertile women may be one of the important reasons which resulted in the poor development of the gland opening and the capillary vessel.