激活素、卵泡抑素因子与多囊卵巢综合征患者卵泡发育障碍的关系

Relationships between activin,follistatin and follicular development disorder of patients with polycystic ovary syndrome

目的讨论激活素(ACTA)和卵泡抑素(FS)在多囊卵巢综合征(PCOS)患者卵泡发育障碍过程所起作用,同时研究了ACTA和FS是否参与了高胰岛素血症PCOS患者二甲双胍的治疗过程,并分析其原因和意义。方法 ①免疫组织化学法检测了ACTA和FS因子在正常妇女卵巢组织的定位及表达;②采用双抗体夹心酶联免疫吸附技术(Sandwich ELISA)检测了40例正常月经周期妇女卵泡液ACTA、FS因子的表达水平;③ELISA法检测20例PCOS患者,20例二甲双胍治疗后的高胰岛素血症PCOS患者和20例正常月经周期妇女卵泡液中ACTA和FS水平。结果①与未成熟卵组比较,成熟卵组ACTA明显升高,差异有统计学意义(t=3.883,P<0.01),FS明显降低,差异有统计学意义(t=2.861,P<0.05);②与对照组相比PCOS患者ACTA水平明显降低,差异有统计学意义(t=3.883,P<0.01),FS水平明显升高,差异有统计学意义(t=2.539,P<0.05);③与PCOS患者相比,二甲双胍治疗后ACTA水平有升高趋势,但差异无统计学意义(t=1.729,P>0.05),FS水平有降低趋势,但差异无统计学意义(t=0.688,P>0.05)。结论 1ACTA和FS因子与正常妇女卵泡发育有关;2ACTA和FS因子参与了PCOS患者卵泡发育障碍;3ACTA和FS可能也参与高胰岛血素PCOS患者二甲双胍治疗过程。

Objective To explore the roles of activin （ACTA） and follistatin （FS） in pathogenesis of follicular development disorder among patients with polycystic ovary syndrome （PCOS）, research whether ACTA and FS are involved in the treatment course of PCOS pa- tients with hyperinsulinemia by metformin, analyze the causes and significance. Methods Immunohistochemistry was used to detet the lo- cations and expressions of ACTA and FS in ovarian tissues of normal women; double-antibody sandwich ELISA technique （Sandwich ELISA） was used to detect the expression levels of ACTA and FS in follicular fluid of 40 women with normal menstrual cycle ; ELISA was used to detect the levels of ACTA and FS in follicular fluid of 20 PCOS patients 20 PCOS patients with hyperinsulinemia after treatment of metformin, and 20 women with normal menstrual cycle. Results Compared with immature oocyte group, ACTA level in mature oocyte group increased significantly, there was statistically significant difference （t = 3. 883, P〈0. 01 ） ; FS level in mature oocyte group decreased sgnifi- cantly, there was statistically significant difference （t=2. 861, P〈0. 05 ） . Compared with control group, ACTA level in PCOS group de- creased significantly, there was statistically significant difference （t=3. 883, P〈0.01 ）; FS level in PCOS group increased significantly, there was statistically significant difference （t=2. 539, P〈0. 05 ） . Compared with PCOS group, ACTA level in patients after treatment of mefformin showed an increasing trend, but there was no statistically significant difference （ t = 1. 729, P〉0. 05 ） ; FS level in patients after treatment of metformin showed a decreasing trend, but there was no statistically significant difference （t = 0. 688, P 〉 0. 05 ） . Conclusion ACTA and FS are correlated with follicular development of normal women ; ACTA and FS are involved in pathogenesis of follic- ular development disorder of PCOS patients; ACTA and FS might also be involved in the treatment course of PCOS patients with hyperinsu- linemia by metformin.