不明原因复发性流产蜕膜组织中血管内皮生长因子和雌孕激素受体的表达意义

Expression of vascular endothelial growth factor and estrogen-progesterone receptor in decidual tissue of unexplained recurrent abortion

目的:探讨雌孕激素受体和血管内皮生长因子在不明原因复发性流产患者中的临床价值。方法:选择收治的不明原因复发性流产孕妇30例为观察组,再选择同期的正常早孕人工流产孕妇30例为对照组,通过免疫组织化学和逆转录-聚合酶链反应(RT-PCR)方法对两组的子宫蜕膜细胞中的孕激素受体(PR)、雌激素受体(ER)以及血管内皮生长因子(VEGF)水平进行比较。结果:观察组的VEGF水平低于对照组,差异有统计学意义(P<0.05)。观察组ER在蜕膜组织中的表达阳性率低于对照组,差异有统计学意义(P<0.05),两组的PR表达阳性率差异无统计学意义(P>0.05)。经RT-PCR检测,观察组的ER水平低于对照组,差异有统计学意义(P<0.05),两组的PR表达水平差异无统计学意义(P>0.05)。结论:雌激素受体表达偏低可能是不明原因复发性流产的原因之一,ER水平低使子宫内膜对激素的反应性降低,导致子宫内膜发育不良,对胚胎的容受性降低,故ER异常直接影响到激素作用结果,可考虑适当地加用戊酸雌二醇增加保胎成功率,给临床上单用孕激素治疗效果不佳的患者在诊疗上提供了一个新的思路,具有重要的临床研究意义。

Objective To investigate the clinical value of estrogen and progesterone receptor and vascular endothelial growth factor in patients with unexplained recurrent abortion.Method 30 pregnant women with unexplained recurrent abortion were selected as the observation group,and then 30 pregnant women with normal early pregnancy abortion in the same period to compare the two levels of progesterone receptor(PR),estrogen receptor(ER)and vascular endo thelial growth factor(VEGF)by immuno hist o chemistry and reverse recording-polymer ase chain reaction(RT-PCR)methods.Results The VEGF levels of the observation group were lower than the control group(P<0.05),the positive rate of ER in the observation group was lower than the control group(P<0.05),There was no difference in PR expression between the two groups(P>0.05),and the ER expression in the observation group was lower than that in the control group(P<0.05),but there was no difference in PR expression(P>0.05).Conclusion Low estrogen receptor expression may be one of the causes of unexplained recurrent abortion.Low ER levels reduce the endometrial response to the hormone,resulting in endometrial dysplasia and reduced tolerance to the embryo,so ER abnormalities directly affect the horm onal results,It can be considered to appropriate addition of estradiol valerate can increase the success rate of fetal preservation,which provides a new idea for with poor clinical effect of progesterone treatment,and has important clinical significance.