经皮穴位电刺激对高龄妇女卵细胞质量及Bcl-2、Bax的影响

摘要

ObjectiveTo observe the effect of transcutaneous acupoint electrical stimulation (TAES) on the ovariangranulosa cell apoptosis-related proteins, Bcl-2 and Bax, as well as the oocyte quality in theolder women with kidney deficiency receiving in vitro fertilization-embryo transfer (IVF-ET).MethodSixty-six older women with kidney deficiency who were receiving IVF-ET because of the fallopian tube factor were randomized into a treatment group (intervened by TAES) and a control group (intervened by sham acupuncture), 33 in each group. The kidney-deficiency syndrome score, HCG E2/follicle count per day, excellent follicle rate, excellent embryo rate, and clinical pregnancy rate were observed and compared between the two groups; Western blot was used to detect the expression of protein Bcl-2 and Bax.ResultCompared to the control group, the treatment group had significant improvement in kidney-deficiencysymptoms (P<0.01), significant increases in theHCG E2/follicle count per day, excellent follicle rate, and excellent embryo rate (P<0.05), enhanced expression of Bcl-2 protein (P<0.01), and decreased expression of Bax protein (P<0.01); while there were no significant differences in comparing theretrievedoocyte number and clinical pregnancy rate (P>0.05). The expression of Bcl-2 and Bax proteins were markedlycorrelatedwith IVF-related indexes (P<0.05).ConclusionTAES can improve the kidney-deficiency symptoms and the quality of oocyte and embryo inolder women; this action is possibly related to the regulation of expression of the cell apoptosis-related protein Bcl-2 and Bax, as well as the decrease ofgranulosecell apoptosis.%目的：观察经皮穴位电刺激对体外受精-胚胎移植(IVF-ET)周期肾虚高龄妇女卵颗粒细胞凋亡相关蛋白 Bcl-2、Bax表达及卵细胞质量的影响。方法将66例因输卵管因素行IVF-ET的肾虚高龄妇女随机分为治疗组(经皮穴位电刺激治疗)和对照组(伪针),每组33例。观察两组患者肾虚证候积分变化,HCG日单个卵雌激素(E2/卵泡数)、优卵率、优胚率、临床妊娠率的差异,并应用蛋白印迹法(Western blot)检测卵颗粒细胞Bcl-2、Bax蛋白表达。结果与对照组相比,治疗组患者肾虚症状明显改善(P＜0.01),HCG日E2/卵泡数、优卵率、优胚率明显升高(P＜0.05),Bcl-2蛋白表达明显增多(P＜0.01),Bax蛋白表达明显降低(P＜0.01),获卵数和临床妊娠率无显著差异(P＞0.05)。Bcl-2、Bax蛋白表达与IVF相关参数有明显相关性(P＜0.05)。结论经皮穴位电刺激能改善高龄妇女肾虚症状,提高卵细胞及胚胎质量,此作用可能与调节颗粒细胞凋亡相关蛋白Bcl-2、Bax的表达,降低颗粒细胞凋亡有关。