不孕患者增生晚期子宫内膜厚度与雌激素受体α、妊娠关系的研究

Relevant Analysis of Endometrial Thickness and Estrogen Receptor-α with Pregnancy in Infertile Patients with Advanced Endometrial Hyperplasia

目的 探讨子宫内膜厚度（EMT）与子宫内膜雌激素受体α（ERα）、临床妊娠率的关系.方法 选取2012年5月-2013年12月期间在广州市番禺何贤纪念医院就诊的80例不孕患者为研究对象,根据注射绒毛膜促性腺激素（HCG）当日,B超检查的EMT进行分组：子宫内膜薄型组35例,子宫内膜正常组45例.提取子宫内膜组织,以免疫组化法测定其ERα表达水平,观察两组患者的年龄、临床妊娠率、EMT、性激素水平、ERα表达水平的差异及各指标间的相关性.结果 子宫内膜薄型组患者年龄显著高于子宫内膜正常组;子宫内膜薄型组EMT及子宫内膜ERα表达水平显著低于子宫内膜正常组,差异具有统计学意义（P＜0.05或P＜0.01）;两组患者的临床妊娠率、性激素水平差异无统计学意义（P＞0.05） ;EMT与ERα表达水平呈正相关（P＜0.05）,与年龄、性激素水平、妊娠率均无显著相关性（P＞0.05）.结论 薄型子宫内膜女性的年龄较大,ERα表达水平低下.

Objective To explore the relationship of endometrial thickness （EMT） and estrogen receptor-a （ERa） with clinical pregnant rate in infertile patients with advanced endometrial hyperplasia. Methods A total of 80 infertile patients treated in our hospital from May 2012 to December 2013 served as study objects and were divided into experimental group （35 cases） and control group （45 cases）according to the EMT tested by B-ultrasound after injection of human chorionic gonadotropin （HCG）. Endometrial tissues were collected to determine the ERa expression by immunohistochemical method. Age, clinical pregnant rate, EMT, sex hormone levels, ERct expression levels between two groups and the relevance between each index were observed. Results Experimental group was evidently higher in age but obviously lower in EMT and ERa expressions than control group, and the differences were significant （P〈0. 05 or P〈 0. 01 ）. There were no significant differences between two groups in clinical pregnant rate and sex hormone level （P〈0.05）, but EMT was in positive relation with ERa expression （P〈0. 05 ）, and was not markedly associated with age,sex hormone level and clinical pregnant rate （P〉0.05）. Conclusion Thin endometrium is found in females of older age with lower ERa expression, which may also impact terminal pregnant outcome.