白血病抑制因子及其受体在原发性不孕症患者子宫内膜中的表达分析

Expression of Endometrial LIF and LIFR in Women with Primary Infertility

目的探讨白血病抑制因子(leukemiainhibitoryfactor,LIF)及其受体(leukemiainhibitoryfactor receptor,LIFR)在原发性不孕症患者种植窗期子宫内膜中的表达情况,分析其与不明原因不孕症的关系。方法采用前瞻性临床对照研究方法,随机选择本院2015年7月～2017年7月诊治的原发性不孕症患者200例为观察组,按照不同的发病原因等分为4个亚组:A组(输卵管闭塞)、B组(卵巢功能低下)、C组(子宫内膜异位)及D组(不明原因),同时选择同期健康志愿者50例为对照组。采用逆转录聚合酶链反应(RT-PCR)技术,分别检测各组研究对象LIFm RNA和LIFRm RNA表达水平,比较组间差异。结果对照组LIFmRNA表达水平为(1.12±0.46),A、B、C、D四个亚组则分别为(1.03±0.33)、(0. 90±0. 30)、(0. 99±0. 38)和(0. 50±0. 31)。A、 B、C三组L I Fm R N A表达水平和对照组的差异无统计学意义(P均>0.05),而D组LIFmRNA表达水平明显低于对照组(P <0.01),组间比较D组和A、B、C三组的差异均有统计学意义(P均<0.01)。A、B、C、D四个亚组LIFRmRNA表达水平均较对照组明显下降(P <0.01),而亚组间比较差异无统计学意义(P均>0.05)。结论女性不孕群体子宫内膜内LIFR显著受损,推断LIFR可能是调节女性子宫内膜种植窗期受孕的关键因子之一。LIF表达缺失可能与不明原因的不孕症发病有关。

Objective To explore the expression of Leukemia inhibitory factor(LIF )and Leukemia inhibitory factor receptor (LIFR) signal in the primary infertile women endometrium with different causes during the implantation window and the relationship between LIF、LIFR and unexplained infertility. Methods In the prospective clinical controlled study,200 patients with infertile from Jan.2015 to Jan.2017 in our hospital were divided randomly into tubal factor(group A),poor ovarian reserve(group B),endometriosis (group C) and unexplained infertility (group D) according to different pathogenesis.Then,normal women were selected during the same period as the control group,the endometrial expression of LIF and LIFR were detected by fluorescence quantitative PCR,while the differences were compared between groups. Results The expression level of LIF in the control group was (1.12±0.46),while in A,B,C and D group were (1.03±0.33),(0.90±0.30),(0.99±0.38) and (0.50±0.31),respectively.There was no significant difference in the expression of LIF between the three groups of A,B,C and the control group,but the expression level of LIF in D group was significantly lower than that of the control group(P<0.01). The endometrial expression of LIF was significantly decreased in D groups than that of the other infertile groups.The endometrial LIFR in four infertile groups were all significantly decreased (P<0.01), while there was no statistical difference between the subgroups (P>0.05). Conclusion The endometrial LIFR expression in general infertile women might be impaired,which deduced that LIFR might be one of the key factors for the pregnant regulation in female endometrial planting window. Deletion of LIF may be associated with unexplained infertility.