ADM低表达与月经过多及原因不明性不孕的关系  

The Relationship of Low ADM Expression with Menorrhagia and Infertility

作　　者：哈春芳[1,2] 窦海丽 曹丹[1,2] 张红[1,2] 

机构地区：[1]宁夏医科大学总医院妇产科 [2]宁夏医科大学生育力保持重点实验室,银川750004 [3]宁夏银川市第四人民医院妇产科,银川750021

出　　处：《宁夏医科大学学报》2013年第4期365-367,385,共4页Journal of Ningxia Medical University

基　　金：国家自然基金项目(81160078)

摘　　要：目的探讨肾上腺髓质素(adrenomedullin,ADM)及其相关受体降钙素受体相关受体(calcitonin relativereceptor,CRLR)在月经过多及原因不明不孕发生中表达及其与内膜血管密度的关系。方法免疫组化、荧光定量PCR法测定月经过多组妇女(n=20)、原因不明的不孕组妇女(n=22)黄体期子宫内膜中ADM、CRLR蛋白和基因表达、血管数目等的变化,选取健康妇女黄体期子宫内膜(n=20)做对照组。结果免疫组化结果显示子宫内膜腺体中ADM蛋白的表达三组间差异均无统计学意义(P>0.05),而间质细胞中ADM表达不孕症组为(768±213.6),月经过多组为(907±286.6),均低于正常对照组(1243±342.8),P<0.001;在腺上皮、腺体及间质中三组间CRLR蛋白表达差异均无统计学意义(P>0.05);QRT-PCR测定显示对照组内膜中的ADM mRNA表达为(4.5±0.70),较不孕症组(1.69±0.51)的高4.12倍,较月经过多组(0.73±0.56)的高5.6倍,而CRLR mRNA表达三组间比较差异无统计学意义;CD31标示的子宫内膜中微血管密度测定结果显示:不孕症组内膜中微血管密度值(1.03±0.51)、微血管总数目(4.9±0.87)明显低于对照组(P<0.01);月经过多组微血管密度(1.12±0.22)、总微血管数目(5.14±0.94)均低于对照组(P<0.01)。结论原因不明性不孕及月经过多的患者发生与子宫内膜中ADM蛋白和mRNA的呈低表达及血管密度的降低有关;原因不明性不孕与月经过多可能同为低ADM表达所致的内膜血管异常性疾病。Objective To investigate the different expression of ADMmRNA and CRLR both in endometrium of unexplained infertility and menorrhagia women , in order to demonstrate the relationship among them. Methods The endometrium from 22 unexpected infertile women, 20 menorrhagia women in luteal phase and 20 fertile women in luteal phase was studied with Immunohistrochemistry, RT - PCR and quantitative RT - PCR. The different expression of ADM and CRLR and vessels densinty in pratein and mRNA were analyse. Results The results of the immunohistochemistry indicated that the expression of ADM in glandular epitheli-um in infertiity group was no more than that in the menorrhagia group and in normal controls; The expression of ADM was appeared mainly in gland with no different staining in three groups （P 〉 0.05 ） ; in the interstitial cells, the expression of ADM in infertiity group was （768 ±213.6） ,which was lower than that the menorrha-gia group （907 ± 286.6 ） ; both of them were lower than the normal controls （ 1243 ± 342.8 ） （ P 〈 0.05 ）. Also by this mean ,there were no different in glandular epithelium and gland , including in the interstitial cell. The expression of CRLR. Q-PCR showed that the expression of ADM mRNA in the normal control＇s endometrium was （4.5 ±0.70）,which was 4.12 times higher significantly than that in infertility（ 1.69 ±0.51 ）, also 5.6 times higher significantly than that in menorrhagia group, while the expression of CRLR mRNA was same in three groups. The vessels densinty staining in infertile group was （1.03 ±0.51 ）, and was （1.12 ±0.22） in menorrhagia, both of them were significantly lower than the value in fertile group （P 〈 0.01 ）. Conclusion The expression of ADM mRNA in the strome cells has correspondence with unexpected infertile and menorrhagia;Both unexpected infertility and menorrhagia may be the result of vessel pathology of the lower expression of ADM.

关 键 词：肾上腺髓质素 降钙素受体相关受体 原因不明性不孕 月经过多 内膜血管疾病 

分 类 号：R711.6[医药卫生—妇产科学]