子宫内膜吸刮术对着床相关因子及反复着床失败患者妊娠结局的影响  

Influence of Endometrial Suction Curettage on Correlation Factors for Implantation and Pregnancy in Women With Repeated Implantation Failure

作　　者：杨丽[1] 姜俊怡[2] 乔鹏云[2] 任春娥[2] 

机构地区：[1]潍坊医学院,山东省潍坊市261031 [2]潍坊医学院附属医学院

出　　处：《中国全科医学》2015年第14期1655-1658,1662,共5页Chinese General Practice

基　　金：山东省科技发展计划项目(2012YD18069)

摘　　要：目的探讨子宫内膜吸刮术对整合素αVβ3和骨桥蛋白（OPN）水平及反复着床失败患者再次行体外受精-胚胎移植（IVF-ET）临床妊娠结局的影响。方法选取2010年9月—2013年9月于潍坊医学院附属医院生殖医学中心连续就诊的148例反复着床失败的不孕症妇女,采用随机数字表法分为试验组和对照组,各74例。试验组于再次IVF-ET周期前1个月经周期第8~10天时行子宫内膜吸刮术,对照组未行。两组患者均采用长方案超促排卵。采用免疫组化法检测两组患者着床期子宫内膜组织中整合素αVβ3和OPN的表达程度,比较两组患者的妊娠结局。结果试验组进行吸刮术后,整合素αVβ3和OPN的表达总染色评分〔（6.4±1.2）、（6.8±1.3）分〕均高于吸刮术前〔（4.1±0.8）、（3.6±0.7）分,P〈0.05〕及对照组〔（4.5±0.8）、（3.7±0.8）分,P〈0.05〕。试验组和对照组妊娠患者的整合素αVβ3和OPN表达总染色评分均高于非妊娠患者,差异有统计学意义（P〈0.05）。试验组临床妊娠率、胚胎着床率及继续妊娠率分别为41.9%（31/74）、22.6%（42/186）、37.8%（28/74）,高于对照组的21.6%（16/74）、11.5%（21/183）、17.6%（13/74）（P〈0.05）。结论整合素αVβ3和OPN与胚胎着床密切相关,子宫内膜吸刮术可增强二者的表达,增加子宫内膜容受性,提高胚胎着床率,从而改善反复着床失败患者行再次IVF-ET的妊娠结局。Objective To investigate the influence of endometrial scratching on the expression of integrin αVβ3 and osteopontin. Demonstrating the relationship with IVF - ET pregnancy outcomes in patients with repeated implantation failure. Methods A total of 148 cases of infertility women with infertility and repeated implantation failure who received continuous treatment in the Reproductive Medicine Center in Affiliated Hospital of Weifang Medical University from September 2010 to September 2013 were enrolled and divided into trial group（n = 74）and control group（n = 74）using random number table. Trial group operated endometrial scratching before performed IVF - ET,while control group did not undergo endometrial scratching. The wo groups were treated with long protocol controlled ovarian hyperstimulation. The expression of integrin αVβ3 and OPN were detected by immunohistochemistry before and after patients undergoing endometrial scratching/ biopsy. Pregnancy outcomes were also compared between these two groups. Results After performing endometrial scratching in experimental group, the expression H - score of integrin αVβ3 and OPN were significantly higher than surgery before〔（6. 4 ± 1. 2） vs. （4. 1 ± 0. 8）;（6. 8 ± 1. 3）vs. （3. 6 ± 0. 7）,P 〈 0. 05〕and control group〔（6. 4 ± 1. 2）vs. （4. 5 ± 0. 8）;（6. 8 ± 1. 3）vs. （3. 7 ± 0. 8）,P 〈 0. 05〕. In these two groups,we also observed that the expression H - score of integrin αVβ3 and OPN were significantly higher in patients with postoperative pregnancy than non - pregnant（P 〈 0. 05）. Besides,clinical pregnancy rate,＆amp;nbsp;embryo implantation rate and ongoing pregnancy rate of experimental group were 41. 9% （31 / 74）、22. 6% （42 / 186）、37. 8%（28 / 74）,which were significantly higher than control group of 21. 6% （16 / 74）、11. 5% （21 / 183）、17. 6% （13 / 74）（P〈 0. 05）. Conclusion Endometrial scratching markedly promoted the expression of integrin αVβ3 and OPN,which are i

关 键 词：胚胎植入 刮宫术 整合素ΑVΒ3 骨桥蛋白质 体外受精 胚胎移植 

分 类 号：R615[医药卫生—外科学] R714.24[医药卫生—临床医学]