反复流产子宫内膜DBA结合特性与外周血激素水平相关性探讨

Correlation of DBA-binding activity of endometrium to serum hormone levels repeated spontaneous abortion

目的探讨反复流产的原因。方法采用免疫组化Ｓ－Ｐ法，以双花藕豆凝集素（ＤＢＡ）为探针，研究２８例无明显原因反复流产者分泌期子宫内膜糖复合物变化的同时，放免法检测血雌二醇（Ｅ２）、孕酮（Ｐ）、泌乳素（ＰＲＬ）、睾酮（Ｔ）水平。结果ＤＢＡ与子宫内膜的结合表现出阶段特异性，其与宫内膜组织相互呈有意义的正相关（Ｐ＜００５）；与血Ｅ２水平呈有意义的负相关（Ｐ＜００５）；并在组织学分泌早期与血Ｐ呈有意义的正相关（Ｐ＝００１）。结论子宫内膜上与ＤＢＡ特异结合的糖复合物与孕卵的着床有关；血Ｅ２水平下降，有利于与ＤＢＡ特异结合的糖复合物的表达；分泌早期，Ｐ在Ｅ２作用基础上，促进与ＤＢＡ特异结合的糖复合物分泌。

Objective\ To explore the causes of repeated spontaneous abortion (RSA). Methods\ In 28 cases of RSA without obvious causes, the changes of glycoconijugate expression on the endometrial surface in secretory phase were studied by an immunohistochemical method(s-p staining),used dolichos biflorus agglutinin (DBA) as probe and the serum levels of estrogen (E 2), progesterone (P), prolactin (PRL), and androgen (T) were measured simultaneously. Results: DBA-binding activity of endometrium showed stage-specific alteration. DBA-binding rate had a positive correlation with endometrial histomophology in secretory phase (p<0.05), and had a negative correlation with the serum level of E 2 (p<0.05). In early secretory phase (2 nd to 5 th day),the binding rate closely correlated to the serum level of P ( P =0.01). Conclusions\ DBA-binding glycoconjugate on the surface of endometrium was associated with adhesion and implantation of blastocyst. The decreasing E 2 was beneficial to the expression of DBA-binding glycoconjugate; in early secretory phase, P, primed by E 2, could stimulate the secretion of DBA-binding glycoconjugate.