控制超排卵周期中血清及卵泡液肿瘤坏死因子-α的水平  

MEASUREMENT OF TUMOR NECROSIS FACTOR-α IN HUMAN SERUM AND FOLLICULAR FLUID IN CONTROLLED OVARIAN HYPERSTIMULATION CYCLE

作　　者：李铭婷 赵志明[2] 徐素欣[2] 崔娜[2] 曹金凤[2] 郝桂敏[2] 

机构地区：[1]河北省秦皇岛市海港医院妇产科,河北秦皇岛066000 [2]河北医科大学第二医院生殖医学科,河北石家庄050000

出　　处：《河北医科大学学报》2009年第9期913-916,共4页Journal of Hebei Medical University

基　　金：河北省科技攻关计划指导课题(12761179)

摘　　要：目的观察控制超排卵过程中肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)在血清和卵泡液中的变化,以探讨TNF-α在卵巢局部生殖调节中的作用。方法收集2008年6—10月在河北医科大学第二医院生殖医学科接受超排卵治疗的60例患者取卵日的血清和卵泡液,用放射免疫法、酶联免疫吸附法分别测定TNF-α、雌二醇(estradiol,E_2)和孕酮(progesterone,P)水平。其中10例在超排卵周期中卵泡早期、卵泡中期采血观察TNF-α水平的变化。结果①在超排卵周期中,血清TNF-α水平随着卵泡发育而逐渐降低,差异有统计学意义(F=70.1153,P<0.01);②取卵日卵泡液TNF-α水平为(430.70±51.40)ng/L,血清TNF-α水平为(38.40±4.98)ng/L(t=115.297,P<0.01);③取卵日血清与卵泡液中TNF-α与E_2水平呈显著负相关关系(r=-0.363,P<0.01;r=-0.421,P<0.01),与P水平无相关性;④随着获卵数的增加,卵泡液中TNF-α水平显著降低(r=-0.417,P<0.05);⑤妊娠组24例卵泡液TNF-α水平为(453.70±33.50)ng/L,非妊娠组36例为(402.80±28.90)ng/L(t=2.5731,P<0.05)。结论卵泡是血清中TNF-α的主要来源,TNF-α水平可能受E_2调节。TNF-α水平可能影响卵子的发育,参与控制超排卵的内分泌机制。Objective To analyze the expression patterns of tumor necrosis factor-α(TNF-α), estradiol(E_2) and progesterone(P) in serum and follicular fluid(FF) of patients undergoing gonadotropins stimulation for assisted reproductive techniques and explore the role of TNF-α in local ovarian reproduction.Methods Serum and FF were obtained from 60 patients at the time of transvaginal oocyte retrieval after superovulation in vitro fertilization (IVF) and embryo transfer (ET).In addition,serum of 10 of the 60 subjects were collected on the day of early follicular stage and mid follicular stage.TNF-α levels in the serum and FF were measured in duplicate by radioimmune assay(RIA).E2 and progesterone levels were measured by a solid phase enzyme-linked immunosorbant assay (ELISA).Results ①During the process of controlled ovarian hyperstimulation(COH),the TNF-α level decreased gradually according to follicular development ( F =70.115 3,P <0.01).②The concentrations of TNF-α in follicular fluid and serum were (430.70±51.40)ng/L and (38.40 ± 4.98) ng/L,respectively ( t =115.297,P <0.01).③A negative correlation was found between the levels of TNF-α and the levels of estradiol in the serum and FF ( r = -0.363,P <0.01; r = -0.421,P <0.01).No correlation was found between the levels of TNF-α and the levels of progesterone in the serum and FF.④The level of TNF-α in follicular fluid decreased significantly in terms of the increase of the number of harvested oocyte ( r = -0.417,P < 0.05).⑤A significant difference in TNF-α levels of the follicular fluid between pregnant patients [(453.70 ± 33.50)ng/L,n =24],and non pregnant patients [(402.80 ± 28.90) ng/L,n = 36 ] was observed (t =2.573 1,P < 0.05). Conclusion Follicles are major source of TNF-α in the serum.The level of TNF-α in serum may be regulated by estradiol.TNF-α may be involved in the follicle development and ovulation via an autocrine/paracrine mechanism within the follicular microenviroment.

关 键 词：肿瘤坏死因子Α 卵泡液 血清 超排卵 

分 类 号：R711.6[医药卫生—妇产科学]