COX-2在多囊卵巢综合征患者子宫内膜的表达

Expression of cyclooxygenase-2 in endometrium of cases with polycystic ovary syndrome

目的:探讨环氧合酶-2(COX-2)在多囊卵巢综合征(PCOS)患者子宫内膜的表达及治疗后的变化。方法:选择PCOS患者(PCOS组)16例,另选择卵巢功能正常的不孕患者20例为对照组,PCOS组应用二甲双胍/达英-35治疗。所有病例均测体重指数(BMI),抽血测定女性激素六项并行75 g葡萄糖耐量试验(OGTT)和胰岛素释放试验(1RT)。于月经干净3～5天(闭经患者确认为卵泡期)刮取子宫内膜组织,采用免疫组织化学技术检测PCOS组治疗前后及对照组子宫内膜COX-2的表达。结果:PCOS组患者BMI\HOMA-IR、空腹胰岛素(I0)、75 g葡萄糖负荷后2 h胰岛素(I120)及T均明显高于家族史阴性患者(P均<0.01);PCOS组治疗前COX-2在子宫内膜的表达显著高于对照组(P<0.01),治疗后其表达明显下降(P<0.05)。结论:PCOS患者子宫内膜可能处于一种慢性炎症状态,子宫内膜COX-2过度表达可能是导致患者子宫内膜异常增生和不孕的原因之一,二甲双胍/达英-35可逆转此变化。

Objective：To explore the expression of cyclooxygenase-2（COX-2） in endometrium of patients with polycystic ovary syndrome（PCOS） and its change after treatment.Methods：16 cases with PCOS（PCOS group） and 20 infertile women with normal ovarian function（control group） were selected,the cases in PCOS group were treated with metformin/diane-35.Body mass index（BMI） was detected,blood samples were extracted to detect six kinds of sex hormones,75 g oral glucose tolerance test（OGTT） and insulin release test（IRT） were performed;the endometrial tissues were scraped at 3～5 days after menstruation was clean（at follicular phase for the cases with amenorrhea）,immunohistochemical method was used to detect the expression levels of COX-2 in COS group（before and after therapy） and control group.Results：The levels of BMI/HOMA-IR,fasting insulin（I0）,2-hour insulin after 75 g glucose load（I120） and testosterone in PCOS group were significantly higher than those in control group（P〈0.01）;the expression level of COX-2 in COS group（before therapy） was significantly higher than that in control group（P〈0.01）,after therapy,the expression level of COX-2 decreased significantly（P〈0.05）.Conclusion：Chronic inflammation maybe exist in endometrium of patients with PCOS,the over-expression of COX-2 may be an potential reason for abnormal hyperplasia of endometrium and infertility,metformin/diane-35 may inhibit the change.