反复种植失败患者外周血miR-145水平变化及对纤溶酶原激活物抑制因子-1的影响

Changes of peripheral blood miR-145 level and its effect on PAI-1 in patients with repeated implantation failure

目的探讨反复种植失败患者取卵前、胚胎移植前血清miR-145水平变化及对纤溶酶原激活物抑制因子-1(PAI-1)的影响。方法选取2021年1月—2022年6月湖南省郴州市第一人民医院生殖医学中心胚胎反复种植失败(RIF)患者71例为观察组,妊娠成功者551例为对照组。分析miR-145与PAI-1相关性、miR-145与RIF的独立关系,miR-145对RIF的评估价值。结果取卵前、胚胎移植前观察组血清miR-145[(1.09±0.13)ng/mL vs.(0.98±0.14)ng/mL,F=8.419,P=0.004;(1.19±0.16)ng/mL vs.(1.01±0.18)ng/mL,F=58.184,P<0.001]、PAI-1[(21.36±6.28)ng/mL vs.(15.09±7.16)ng/mL,F=6.463,P=0.017;(25.36±6.18)ng/mL vs.(17.32±6.99)ng/mL,F=78.536,P<0.001]水平高于对照组;观察组取卵前、胚胎移植前miR-145与PAI-1均呈正相关关系(r=0.725,P<0.001;r=0.671,P<0.001);取卵前、胚胎移植前miR-145均与RIF独立相关(P<0.05);取卵前、胚胎移植前miR-145评估RIF的AUC值分别为0.690、0.774。结论RIF不孕症患者miR-145呈异常高表达,其可能通过靶向调节PAI-1表达降低子宫内膜容受性,参与RIF的发生过程。

Objective To investigate the changes of serum miR-145 levels and their impact on plasminogen activator inhibitor 1(PAI-1)in patients with repeated implantation failure before egg retrieval and embryo transfer.Methods A total of 71 cases of repeated implantation failure(RIF)in the Reproductive Medicine Center of the First People's Hospital of chenzhou were included in the observation group,and 551 cases of successful pregnancy were included in the control group.The correlation between miR-145 and PAI-1,the independent relationship between miR-145 and RIF,and the evaluation value of miR-145 on RIF were analyzed.Results The levels of miR-145[(1.09±0.13)ng/mL vs.(0.98±0.14)ng/mL,F=8.419,P=0.004;(1.19±0.16)ng/mL vs.(1.01±0.18)ng/mL,F=58.184,P<0.001]and PAI-1[(21.36±6.28)ng/mL vs.(15.09±7.16)ng/mL,F=6.463,P=0.017;(25.36±6.18)ng/mL vs.(17.32±6.99)ng/mL,F=78.536,P<0.001]in the observation group were higher than those in the control group before egg retrieval and embryo transfer.There was a positive correlation between miR-145 and PAI-1 in the observation group before egg retrieval and embryo transfer(r=0.725,P<0.001;r=0.671,P<0.001).miR-145 was independently correlated with RIF before egg retrieval and embryo transfer(P<0.05).The AUC values of RIF evaluated by miR-145 before egg retrieval and embryo transfer were 0.690 and 0.774,respectively.Conclusion Patients with RIF infertility have abnormally high expression of miR-145,and it may reduce endometrial receptivity by targeting PAI-1 expression,thus participating in the process of RIF.