内皮型一氧化氮合酶表达及微血管密度评估体外受精患者子宫内膜容受性的价值

The Value of Endothelial Nitric Oxide Synthase Expression and Microvessle Density on Assessing the Endometrial Receptivity of IVF Patients

目的:探讨着床窗口期子宫内膜内皮型一氧化氮合酶(eNOS)蛋白表达及微血管密度(MVD)评估体外受精-胚胎移植(IVF-ET)助孕患者子宫内膜容受性的价值。方法:纳入IVF-ET助孕患者60例,于移植前一周期着床窗口期行子宫内膜取样,采用免疫组织化学SP法检测eNOS蛋白的表达及MVD,逆转录-聚合酶链反应(RT-PCR)法检测eNOS mRNA的表达。根据临床妊娠结局分为妊娠组(30例)和未妊娠组(30例),比较两组eNOS mRNA、蛋白表达及MVD的差异。结果:妊娠组eNOS mRNA(0.72±0.21)明显高于未妊娠组(0.29±0.12),差异有统计学意义(P<0.05);妊娠组子宫内膜eNOS蛋白阳性表达率(80.0%)明显高于未妊娠组(13.3%),差异有统计学意义(P<0.05);妊娠组MVD(14.53±3.28)明显高于未妊娠组(12.20±3.83),差异有统计学意义(P<0.05);子宫内膜eNOS蛋白表达水平与MVD呈正相关(r=0.814,P<0.01)。结论:着床窗口期子宫内膜eNOS mRNA及蛋白的高表达和MVD增加均能够改善子宫内膜容受性,有利于IVF妊娠结局。

Objective：To evalute the effects of expressions of endothelial nitric oxide synthase （eNOS） and microvessle density（MVD） in endometrial receptivity of IVF-ET patients. Methods：A total of 60 cases of IVF-ET patients during the implantation window before the IVF cycle were selected for endometrial sampling,immunohis- tochemistry was used to detect the expression of eNOS protein and MVD, reverse transcription polymerase chain reaction to detect the expression of eNOS mRNA. According to the clinical pregnancy outcome, patients was divided into pregnant group（30 cases） and non-pregnant group（30 cases） and comparing the mRNA and protein of eNOS , MVD between the two groups. Results：The eNOS mRNA in the pregnant group（0. 72 ± 0. 21 ） was significantly higher than that in non-pregnant group （0.29 ± 0. 12 ）, the difference was statistically significant （ P 〈 0. 05） ;The positive expression rate of eNOS protein in the pregnant group（80.0%） was significantly higher than that in non-pregnant group（13. 3% ） ,the difference was statistically significant（ P 〈0.05） ;The MVD in the pregnant group（ 14.53 ±3. 28） was significantly higher than that in non-pregnant group（ 12.20 ~3.83）, the difference was statistically significant（ P 〈0.01 ） ;The endometrial eNOS expression level was positively correlated with MVD （ r = 0. 814 ; P 〈 0.05）. Conclusions ：The up-regulated expression of MVD ,eNOS mRNA and protein during implantation window phase could help to improve the endometrial receptivity and increase embryo implantation chance.