不孕患者子宫内膜孕激素受体研究

Endometrial nuclear progesterone receptors in infertile women

目的 探讨不孕患者黄体中期子宫内膜孕激素受体 (PgR)的含量及其与子宫内膜分泌延迟的关系。方法 应用12 5I放射免疫法及免疫组织化学LSAB法 ,对 5 3例不孕患者做了黄体中期血孕酮及子宫内膜活体组织检测。以尿黄体生成素 (LH)高峰日为标准测定黄体期实际天数 ,将子宫内膜分泌表现较实际天数延迟 2天以上者诊断为黄体功能不全。并根据血孕酮值及子宫内膜活检结果将患者分为 3组 :正常组、假黄体功能不全组、黄体功能不全组。结果 发现假黄体功能不全及黄体功能不全患者 2 4例 ,均于黄体中期表现子宫内膜分泌延迟。假黄体功能不全 9例中血孕酮值正常平均为 6 0 .2nmol/L ,其子宫内膜PgR含量为 144 .2 ,较正常组明显低下 (P <0 .0 1)。黄体功能不全 15例血孕酮值较正常组明显低下 (P <0 .0 1) ,平均为 2 9.9nmol/L ,但其子宫内膜PgR含量与正常组比较差异无显著性 (P >0 .0 5 )。结论 子宫内膜分泌延迟是由两种不同原因引起 。

Objective To investigate the endometrial nuclear progesterone receptors (PgR) as well as its relationship with retarded endometrial development(RED)in infertile women. Methods The progesterone profile, endometrial nuclear progesterone receptors (PgR) and endometrial biopsies were studied by using 125 I radioimmunoassay and immunohistochemical technique in 53 infertile women during median luteal phase. When the endometrial dating lagged 2 days behind the dating as determined by luteinizing hormone (LH) surge, diagnosis of luteal phase defect (LPD) was made. According to progesterone profile and endometrial morphology, the patients were divided into three groups: normal, luteal phase defect (LPD) and pseudocorpus luteum insufficiency (PLI). Results During median luteal phase, RED were found in all of 24 cases with LPD and PLI, but PgR contents were different in them. Mean progesterone profile of 9 cases of PLI cycles was normal (60.2 nmol/L) but the endometrial nuclear PgR appeared to be prominently lower than in normal cycles during the median luteal phase ( P <0.01). Average progesterone level of 15 cases of LPD cycles were significantly lower (29.9 nmol/L) but endometrial nuclear PgR were similar to normal group ( P >0 05). Conclusion Retarded endometrial development may have different causes. Measurment of endometrial nuclear PgR is of assistance in differential diagnosis.