子宫内膜异位症合并不孕患者息肉中血管内皮生长因子A与微血管密度的关系  

Correlation between VEGF-A and MVD in endometrial polyp of patients with endometriosis,endometrial polyp and infertility

作　　者：张玉凤 王宁宁[2] 刘庆平 廖桂莲 黄诗华 何冰 江燕妮 

机构地区：[1]佛山市南海区第三人民医院妇产科,广东省528244 [2]中山大学第一附属医院妇科

出　　处：《中华临床医师杂志（电子版）》2011年第22期6631-6636,共6页Chinese Journal of Clinicians(Electronic Edition)

基　　金：广东省医学科学技术研究基金(A2009672);国家自然科学基金(81170550;30672222);广东省自然科学基金(8151008901000124);广东省科技计划项目(2010B050700009);广州市科技计划项目(2010Y-C011)

摘　　要：目的寻找出子宫内膜异位症(EMs)合并子宫内膜息肉(EP)不孕的发病机制。方法随机选取2002年7月至2008年4月在中山大学第一附属医院经临床及病理确诊EMs合并EP育龄妇女,分为研究组和对照组,研究组14例(原发不孕者)包括增殖期9例,分泌期5例;对照组(有妊娠史)23例,增殖期14例,分泌期9例。采用免疫组化SP法,对EP组织进行血管内皮生长因子A(VEGF-A)、CD34检测,结合显微图像进行分析。结果 EMs合并EP的原发不孕患者中,7例息肉在增殖期VEGF-A阳性细胞数为726.93±274.75,EMs合并EP有妊娠史的患者中,14例息肉在增殖期VEGF-A阳性细胞数为535.24±143.05,原发不孕组EP在增殖期VEGF-A阳性细胞较高。EMs合并EP有妊娠史的患者中,14例息肉在增殖期VEGF-A阳性细胞面积的面密度与微血管密度(MVD)的相关系数为0.64,呈正相关(P<0.05),EMs合并EP有妊娠史的患者中,9例息肉在分泌期VEGF-A阳性细胞数与MVD的相关系数为-0.75,呈负相关(P<0.05)。结论 EMs合并EP导致不孕可能与VEGF-A升高有关。在增殖期息肉内VEGF-A与MVD无正相关、分泌期无负相关可能是EMs合并息肉患者的不孕原因之一。Objective To explore the mechanism of infertility in patients with endometriosis(EMs)and endometrial polyp(EP).Methods Patients diagnosed as EMs and EP in the First Affiliated Hospital of Sun Yat-sen University from July 2002 to April 2008 were randomly selected and divided into two groups.There were 14 infertility patients in the case group,9 of their endometrium were in proliferative phase,5 of their endometrium were in progestational phase.There were 23 patients with normal reproductive history in the control group,14 of their endometrium were in proliferative phase,9 of their endometrium were in progestational stage.Immunohistochemistry was used to detect VEGF-A and CD34.Micro-imaging analysis were used to analyze the influence of VEGF-A on MVD.ResultsIn proliferative phase stage,the number of VEGF-A positive cells in EP of 7 infertility patients diagnosed as EMs and EP was 726.93±274.75,it of 14 patients with normal reproductive history was 535.24±143.05,the infertility group were more than that in the control group.In proliferative stage,a correlation coefficient between the percentage of VEGF-A positive cell range and microvascular density(MVD)in EP of 14 patients with normal reproductive history was 0.64,there was positive correlation(P<0.05).In progestational stage,a correlation coefficient between VEGF-A positive cell number and MVD in EP of 9 patients with normal reproductive history is-0.75,there was negative correlation(P<0.05).ConclusionsInfertility in patients with EMs complicated with EP may be related with the up-regulated of VEGF-A.There is no positive correlation between VEGF-A and MVD in proliferative phase and negative correlation between them in progestational stage may play an important role in infertility among patients with both EMs and EP.

关 键 词：子宫内膜异位症 血管内皮生长因子A 不育 女(雌)性 微血管密度 子宫内膜息肉 

分 类 号：R711.71[医药卫生—妇产科学] R711.6[医药卫生—临床医学]