不明原因反复自然流产妇女植入窗期子宫内膜形态及雌孕激素受体的表达  

Changes of morphology and expression of ER and PR in the endometrium of women with unexplained recurrent miscarriage during implantation window phase

作　　者：徐步芳[1] 孙晓溪[2] 冯云 李路[2] 吴煜[2] 高晓红[2] 程利南 

机构地区：[1]上海交通大学医学院附属瑞金医院生殖医学中心,上海200025 [2]上海交通大学医学院附属国际和平妇幼保健院生殖医学中心,上海200030 [3]上海市计划生育研究所,上海200032

出　　处：《生殖医学杂志》2009年第2期94-97,共4页Journal of Reproductive Medicine

摘　　要：目的探讨不明原因反复自然流产(URM)与植入窗期子宫内膜发育程度以及雌、孕激素受体(ER、PR)表达之间的相关性。方法应用光学显微镜、扫描电镜观察URM(试验组)24例生育妇女(对照组)22例子宫内膜组织学,胞饮小泡密度;免疫组织化学分析ER、PR的表达。结果 URM组子宫内膜黄体期缺陷(LPD)的发生率明显高于对照组,胞饮小泡密度低于对照组,子宫内膜上皮细胞核及基质细胞核中PR的表达量也低于对照组,差异有统计学意义(P<0.01)。两组子宫内膜ER的表达未见统计学差异。结论 URM子宫内膜LPD发生率高,胞饮小泡密度明显低于正常生育妇女,提示植入窗期子宫内膜发育滞后可能是导致胚胎着床障碍、反复自然流产的原因之一。在性激素分泌正常的URM妇女中,子宫内膜PR表达下降,对孕激素反应不足可能是导致内膜形态发育滞后的原因。Objective：To explore the degrees of endometrial development and expression （ER） and progesterone receptor （PR） during window phase. in the women with unexplained recurrent of estrogen receptor miscarriage （URM） Methods.The histology, pinopode density and expression of ER and PR were examined by using light microscope, scan electron microscope （SEM） and immunohistochemistry. Results： Compared with that in the normal control group, the luteal phase defect （LPD） rate was higher （P〈0. 05） while the pinopode density was lower （P〈0.01） in URM women. The expression of PR was much stronger in control group than in URM group （P〈0.01）, but the difference of ER expression between two groups was not significant. Conclusions. Significantly higher rate of LPD and lower pinopode density in URM women imply the poor development of endometrium.during window phase which may be one of the etiological factors. Moreover, considering the normal hormone levels in URM women in the present study, the weak PR expression in endometrium during window phase may induce the hysteretic development of endometrium.

关 键 词：反复自然流产 子宫内膜 植入窗 胞饮小泡 黄体期缺陷 孕激素受体 雌激素受体 

分 类 号：R714.21[医药卫生—妇产科学] R714.22[医药卫生—临床医学]