基于CXCL12/CXCR4轴的表达探讨不明原因不孕妇女着床期子宫内膜容受性的差异

Exploration of the difference of endometrial receptivity in unexplained infertile women during implantation based on the expression of CXCL12/CXCR4 axis

目的:分析不明原因不孕妇女子宫内膜中CXCL12/CXCR4轴的表达情况。方法:选取不明原因不孕患者(观察组)和正常生育患者(对照组)各30例。在排卵日使用超声测定2组子宫内膜厚度、分型、容积、内膜下血管化指数(VI)、血流指数(FI)、血管化血流指数(VFI)及子宫两侧动脉PI、RI。检测2组排卵后第7天血清中雌二醇(E2)、促黄体生成素(LH)、孕酮(P)的水平。采用实时荧光定量PCR(RT-qPCR)检测子宫内膜中CXCL12 mRNA和CXCR4 mRNA的表达情况。结果:与对照组相比,观察组子宫内膜厚度偏薄,子宫内膜下Ⅰ型血流比例更大,子宫动脉PI、RI显著增加,子宫内膜下VI、FI和VFI显著下降,CXCL12 mRNA及CXCR4 mRNA表达均显著降低(均P<0.05)。结论:在不明原因不孕妇女中,CXCL12/CXCR4轴低表达可能影响子宫内膜容受性,继而影响临床妊娠,导致不孕。

Objective:To determine the expression of CXCL12/CXCR4 axis in endometrium of women with unexplained infertility.Methods:30 cases with normal fertility(control group)and 30 patients with unexplained infertility(observation group)were enrolled.Various parameters such as endometrial thickness,typing,volume,subendometrial vascularization index(VI),flow index(FI),vascularization flow index(VFI),pulsatility index(PI)and RI of uterine artery were measured by ultrasound on the day of ovulation.Serum levels of estradiol(E2),luteinizing hormone(LH)and progesterone(P)were measured 7 days post-ovulation.RT-qPCR was used to detect the expression of CXCL12 mRNA and CXCR4 mRNA in the endometrium.Results:Compared with the control group,the endometrial thickness in the observation group was thinner,the proportion of subendometrial typeⅠblood flow was greater,uterine artery PI and RI were significantly increased,and subendometrial VI,FI and VFI were significantly decreased,the expressions of CXCL12 mRNA and CXCR4 mRNA were significantly decreased(all P<0.05).Conclusion:Low expression of CXCL12 and CXCR4 axis in women with unexplained infertility may affect endometrial receptivity and subsequently clinical pregnancy,leading to infertility.