人工干预对反复种植失败患者着床窗口期子宫内膜组织中LPAR3和HOXA-11表达的影响  

Influence of manual intervention on LPAR3 and HOXA-11 expressions at the endometrial implantation period in RIF patients

作　　者：赵华[1] 王兴玲[2] 李丽[2] 李豫峰[1] 

机构地区：[1]华中科技大学附属同济医院生殖中心,武汉430000 [2]郑州大学第三附属医院生殖中心,郑州450052

出　　处：《郑州大学学报（医学版）》2015年第6期814-818,共5页Journal of Zhengzhou University(Medical Sciences)

基　　金：河南省科技攻关计划项目2011020054

摘　　要：目的:探讨对反复种植失败(RIF)患者进行人工干预后,着床窗口期子宫内膜组织中溶血磷脂酸受体3(LPAR3)和同源框基因11(HOXA-11)表达变化对临床结局的影响。方法:将92例因输卵管因素不孕的RIF患者分为搔刮组(子宫内膜搔刮,n=31)、中成药组(调经促孕丸,n=31)、未干预组(n=30)。采用RT-PCR和Western blot方法检测3组患者窗口期子宫内膜组织中LPAR3和HOXA-11 mRNA和蛋白表达的情况,并观察3组患者临床妊娠率的差异。结果:搔刮组、中成药组患者窗口期子宫内膜组织中LPAR3和HOXA-11 mRNA及蛋白表达量高于未干预组,差异有统计学意义(F=57.463和60.771,P<0.001;F=48.816和40.313,P<0.001),而前两组比较差异无统计学意义(P>0.05)。搔刮组、中成药组复苏周期临床妊娠率分别是48.4%和32.3%,均高于未干预组(16.7%),差异有统计学意义(χ2=6.908,P=0.032),但前两组比较差异无统计学意义(P>0.05)。结论:子宫内膜搔刮术和口服调经促孕丸2种干预措施均可以改善子宫内膜容受性,提高RIF患者的临床妊娠率。Aim：To investigate the expressions and significance of LPAR 3 and HOXA-11 in the mRNA and protein level at the endometrial implantation phase after the manual intervention in the patients with repeated implantation failure （ RIF） .Methods：According to the RIF patients′willingness of receiving manual intervention and the different intervention methods, the 92 RIF patients with fallopian tube-related infertility were allocated into scratching group （n=31）, Chinese patent medicine group （n=31） and non-intervention group （n=30）.RT-PCR and Western blot were adopted to detect the expressions of LPAR3 and HOXA-11 mRNA and protein at the endometrial implantation phase after the ovulation of the RIF patients.Results：The results of RT-PCR and Western blot showed that the expressions of LPAR 3 and HOXA-11 mRNA and protein in the scratching group and Chinese patent medicine group at the implantation window phase noticeably higher than those in the non-intervention group（F=57.463 and 60.771,P〈0.001;F=48.816 and 40.313,P〈0.001）,howev-er, there was no statistical difference between the former two groups .The clinical pregnancy rate （48.4%） in the scratc-hing group and Chinese patent medicine group （32.3%） was higher than that in the non-intervention group（16.7%）（χ2 =6.908, P〈0.032）,however, the comparison of the former 2 groups revealed no statistical difference （P〉0.05）.Conclu-sion：Two intervention measures , including the endometrial scratching and taking progestational pills , could improve the endometrial receptivity and enhance the clinical pregnancy rate of the RIF patients .

关 键 词：子宫内膜容受性 子宫内膜搔刮术 同源框基因11 溶血磷脂酸受体3 调经促孕丸 反复种植失败 

分 类 号：R711[医药卫生—妇产科学]