PCOS患者子宫内膜病变和胰岛素受体表达的临床研究  

Endometrial pathological changes and expression of insulin receptor protein in the patients with polycystic ovary syndrome

作　　者：罗国群[1] 邓伟芬[1] 柳倩茹[1] 马文敏[1] 王夷黎[1] 杨美琼[1] 

机构地区：[1]广东省佛山市妇幼保健院,528000

出　　处：《中国计划生育学杂志》2013年第1期32-35,共4页Chinese Journal of Family Planning

摘　　要：目的:研究多囊卵巢综合征(PCOS)患者子宫内膜病变和内膜胰岛素受体(IR)的表达,探讨PCOS子宫内膜改变的影响。方法:测定30例PCOS患者外周血清雌二醇(E2)、睾酮(T)、空腹血糖及胰岛素水平,计算稳定模型胰岛素抵抗指数(HOMA-IR),检查子宫内膜病理改变及内膜IR的表达;以不孕症患者(非排卵障碍)30例为对照组。结果:PCOS组43.3%子宫内膜呈增生性改变,内膜癌占3.4%,非增生性子宫内膜占53.3%;内膜增生症、内膜癌及非增生症患者血清E2、T无差异(P>0.05);增生症患者HOMA-IR高于非增生症患者(P<0.05),子宫内膜IR表达高于非增生症患者(P<0.05),子宫内膜IR表达与HOMA-IR呈正相关(r=0.576,P<0.01)。结论:近50%PCOS患者子宫内膜呈不同程度增生性改变,可能与长期持续低量雌激素刺激、胰岛素抵抗-高胰岛素血症有关;高胰岛素血症使胰岛素受体上调,导致子宫内膜的异常增生。Objective ： To study the endometrial histopathology and the expression of insulin receptor in the endometrium of the patients with polycystic ovary syndrome （PCOS）. Methods： A total of 60 patients were recruited, with 30 PCOS patients in the study group and 30 non - PCOS patients with infertility in the control group. Serum levels of estradiol, testosterone, fasting plasma glucose and fasting insulin were determined, and homeostasis model assessment of insulin resistance （ HOMA - IR） were calculate. The endometrial pathology was checked by HE stain, and the expression of insulin receptor in the endometrium was detected by immunohistochemical methods. Results： （1）The normal endometrium, endometrial hyperplasia, endometrial adenocarcinoma were found in 53.3%, 43.3% and 3.4% of PCOS patients, respectively. （2） The serum levels of estradiol, testosterone were not significantly different in the PCOS patients with different endometrial pathological changes （ P 〉 0.05 ）. HOMA - IR was significantly higher in PCOS patients with endometrial hyperplasia than in PCOS patients with normal endome- trium （ P 〈 0.05 ）. （ 3 ） The endometrial expression of insulin receptor in the patients with endometrial hyperplasia was signifi- cantly higher than that of those with normal endometrium （P 〈 0.05）. The expression of insulin receptor in the endometrium was positively correlated with HOMA - IR （ r = 0. 576, P 〈 0.01 ）. Conclusion： Endometrial hyperplastic changes were found in nearly half of the PCOS patients, which may be associated with insulin resistance, hyperinsulinemia and resultant higher en- dometrial expression of insulin receptor.

关 键 词：多囊卵巢综合征 内分泌子宫内膜 胰岛素受体 内膜增生 

分 类 号：R711.75[医药卫生—妇产科学]