复发性流产妇女围植入期子宫内膜HIF-1α、VEGF及微血管的表达和意义

Expressions and significance of HIF-1α,VEGF,and microvessels in endometrium during peri-implantation period in women with recurrent spontaneous abortion

目的探讨复发性流产妇女围植入期子宫内膜缺氧诱导因子-1α(HIF-1α)、血管内皮生长因子(VEGF)及微血管的表达及意义。方法选择2016年4月-2018年1月邵阳市中心医院妇产科收治的58例不明原因复发性流产妇女作为病例组,生育正常妇女40例为正常组,使用Pipelle取样器获得受试者围植入期子宫内膜活组织样本,RT-PCR检测子宫内膜HIF-1α和VEGF mRNA表达水平,免疫组织化学染色法检测子宫内膜HIF-1α和VEGF蛋白表达水平,并计算微血管密度(MVD),分析病例组子宫内膜HIF-1α和VEGF表达水平及意义。结果病例组子宫内膜HIF-1α、VEGF mRNA均显著高于正常组,MVD显著高于正常组,子宫内膜HIF-1α和VEGF蛋白阳性表达率显著高于正常组,差异均有统计学意义(P<0. 05)。HIF-1α蛋白主要在子宫内膜胞质中表达,VEGF蛋白主要在子宫内膜腺上皮中表达。病例组再次流产患者子宫内膜HIF-1α和VEGF表达水平显著高于未流产患者,差异有统计学意义(P<0. 05)。病例组子宫内膜HIF-1α、VEGF表达水平与MVD分别呈显著正相关关系(r=0. 687、0. 724,P<0. 05)。结论复发性流产妇女围植入期子宫内膜HIF-1α和VEGF表达及MVD异常升高,可能是复发性流产发生的病理机制之一。

Objective To explore the expressions and significance of hypoxia-inducible factor-1α(HIF-1α),vascular endothelial growth factor(VEGF),and microvessels in endometrium during peri-implantation period in women with recurrent spontaneous abortion.Methods From April 2016 to January 2018,58 women with unexplained recurrent abortion treated in Shaoyang Central Hospital were selected as case group,and 40 normal women were selected as normal group.Endometrial tissue samples during peri-implantation period were obtained using Pipelle sampler,RT-PCR was used to detect the expressions of HIF-1αand VEGF mRNA,the expressions of HIF-1αptotein and VEGF protein in endometrium were detected by immunohistochemical staining,microvascular density(MVD)was calculated,the expression levels and significance of HIF-1αand VEGF in endometrium of case group were analyzed.Results The levels of HIF-1αand VEGF mRNA,MVD,the positive expression rates of HIF-1αprotein and VEGF protein in case group were statistically significantly higher than those in normal group(P<0.05).HIF-1αprotein was mainly expressed in cytoplasm of endometrium,VEGF protein was mainly expressed in endometrial glandular epithelium;the expression levels of HIF-1αand VEGF in endometrium of patients with recurrent abortion were significantly higher than those of patients without recurrent abortion in case group(P<0.05);there were significant positive correlations between the expressions of HIF-1αand VEGF in endometrium and MVD in case group(r=0.687,0.724,P<0.05).Conclusion Abnormal increases of expressions of HIF-1αand VEGF and MVD during peri-implantation period in women with recurrent abortion may be one of the pathological mechanisms of recurrent abortion.