CD4^(+)/CD8^(+)和自噬蛋白Beclin-1与子宫内膜容受性改变和不孕发生相关性探究

Correlation of CD4^(+)/CD8^(+) and autophagy protein Beclin-1 with endometrial receptivity and infertility

目的:研究CD4^(+)/CD8^(+)和自噬蛋白Beclin-1与子宫内膜容受性改变和不孕发生的相关性。方法:选取2019年2月至2021年4月青海省人民医院收治的137例不孕症患者作为研究对象,另选同期体检的60例健康女性作为对照。流式细胞术检测外周血CD4^(+)、CD8^(+)水平,并计算CD4^(+)/CD8^(+);免疫组化染色法检测Beclin-1表达;阴道彩色多普勒超声诊断仪检测子宫内膜容受性(血流阻力指数、搏动指数、子宫内膜厚度与容积)变化。Spearman分析CD4^(+)/CD8^(+)、Beclin-1阳性表达与子宫内膜容受性相关指标的关系。结果:不孕组CD4^(+)水平、CD4^(+)/CD8^(+)高于健康组,CD8^(+)水平低于健康组(P<0.05)。健康组Beclin-1阳性表达58例,不孕组阳性表达101例,不孕组阳性率(73.72%)低于健康组(96.67%,P<0.05)。不孕组血流阻力指数、搏动指数高于健康组,子宫内膜厚度与容积低于健康组(P<0.05)。Spearman相关性分析显示,CD4^(+)/CD8^(+)与血流阻力指数、搏动指数呈正相关,与子宫内膜厚度与容积呈负相关(P<0.05);Beclin-1阳性表达与血流阻力指数、搏动指数呈负相关,与子宫内膜厚度与容积呈正相关(P<0.05)。结论:不孕症女性外周血CD4^(+)/CD8^(+)显著升高,自噬蛋白Beclin-1阳性表达下调,可能与机体子宫内膜容受性变化与不孕发生密切相关。

Objective:To investigate correlation of CD4^(+)/CD8^(+) and autophagy protein Beclin-1 with changes of endometrial receptivity and occurrence of infertility.Methods:A total of 137 infertility patients in Qinghai Provincial People’s Hospital from February 2019 to April 2021 were enrolled,and another 60 healthy women were set as controls. CD4^(+) and CD8^(+) levels in peripheral blood were detected by flow cytometry,and CD4^(+)/CD8^(+) was calculated. Expression of Beclin-1 was detected by immunohistochemical staining. Endometrial receptivity related parameters(resistance index,pulsatility index,endometrial thickness,endometrial volume)were observed through transvaginal color Doppler ultrasound. Correlation of CD4^(+)/CD8^(+) and Beclin-1 positive expression with endometrial receptivity-related indicators was discussed by Spearman analysis.Results:CD4^(+) level and CD4^(+)/CD8^(+) of infertility group were higher than those of healthy group,and CD8^(+) level was lower than that of healthy group(P<0.05). Fifty-eight cases tested positive for Beclin-1 expression in healthy group and 101 cases in infertility group. Beclin-1 positive expression rate(73.72%)in infertility group was significantly lower than healthy group(96.67%,P<0.05). Compared with healthy group,resistance index and pulsatility index were increased in infertility group,and endometrial thickness and volume were decreased(P<0.05). Spearman correlation analysis denoted that CD4^(+)/CD8^(+) was positively correlated with resistance index and pulsatility index,and negatively correlated with endometrial thickness and volume(P<0.05). Beclin-1 positive expression was negatively correlated with resistance index and pulsatility index,and positively correlated with endometrial thickness and volume.Conclusion:CD4^(+)/CD8^(+) in peripheral blood is abnormally elevated,and positive expression of autophagy protein Beclin-1 is down-regulated in women with infertility,which are closely related to changes in endometrial receptivity and development of infertility.