不明原因复发性流产患者分泌中期子宫内膜血管内皮生长因子和孕激素受体的表达

摘要

目的 检测不明原因复发性流产(URSA)患者分泌中期子宫内膜的血管内皮生长因子(VEGF)和孕激素受体(PR) mRNA及蛋白的表达及探讨其意义.方法 选取2010年6月至2011年10月在广州医学院第三附属医院生殖医学中心和广东省妇幼保健院生殖医学中心及产前诊断科的22例URSA患者为研究组;20例正常妇女为对照组.采用实时荧光定量PCR和免疫组化法检测2组人群分泌中期子宫内膜VEGF和PR的mRNA及蛋白的相对表达水平.结果 VEGF和PR的mRNA和蛋白在两组表达率均为100％;VEGF蛋白表达于腔上皮和间质;PR蛋白表达于腺上皮和间质.研究组VEGF的mRNA和蛋白表达水平均低于对照组(0.16±0.10比0.34±0.22,0.014±0.004比0.018±0.005,均P＜0.05);研究组PR的mRNA和蛋白表达水平均低于对照组(2.52±0.99比4.38± 1.44,0.25±0.02比0.32±0.02,均P＜0.05).结论 URSA患者分泌中期VEGF、PR的相对低表达可能是导致URSA的分子机制之一.%Objective To examine the expressions of vascular endothelial growth factor (VEGF) and progesterone receptor (PR) in ednometrium of mid- secretory phase in patients with unexplained recurrent spontaneous abortion (URSA),and to explore their significance.Methods Between June 2010 and October 2011,22 URSA cases were selected and recruited into research group,and 20 normal women were assigned into control group in Department of Reproductive Medical Center,Guangdong Women and Children Hospital and the Third Hospital of Guangzhou Medical College.Real time quantitative fluorescence PCR (RTQ-PCR) and immunohistochemistry were used to detect the relative expressions of VEGF and PR in endometrium of mid-secretory phase in two groups.Results The expression rates of mRNA and protein of VEGF and PR were 100％ in both two groups.The protein expression of VEGF was in luminal epithelium and mesenchyma and that of PR in glandular epithelium and mesenchyma.The expression levels of mRNA and protein of VEGF and PR in research group were significantly lower than those in control group (0.16±0.10 vs 0.34±0.22; 0.014±0.004 vs 0.018±0.005;2.52±0.99 vs 4.38± 1.44; 0.25±0.02 vs 0.32±0.02,all P＜0.05).Conclusion The relatively lower expression levels of VEGF and PR in endometrium of mid-secretory phase may be one of the mechanisms to cause URSA.