血管紧张素Ⅱ和血管紧张素1-7及其受体在多囊卵巢综合征患者中的表达研究  

The Expression of Angiotensin Ⅱ,Angiotensin 1-7 and Their Receptors in Patients with Polycystic Ovary Syndrome

作　　者：陈丽华[1] 王秀丽[2] 陈静[3] 刘洁[2] 李晓冬[2] 李艳飞[4] 张明乐[2] 张媛[2] 王宇[2] 王慧颖[2] 段晓芬 

机构地区：[1]河北北方学院附属第一医院,河北省张家口市075000 [2]河北医科大学第二医院,河北省石家庄市050000 [3]哈励逊国际和平医院,河北省衡水市053000 [4]河北省沧州市中心医院,061000

出　　处：《中国全科医学》2017年第24期2978-2983,共6页Chinese General Practice

基　　金：河北省重点研发计划项目(16277723D)

摘　　要：目的检测多囊卵巢综合征(PCOS)患者卵泡液中血管紧张素(Ang)Ⅱ、Ang-(1-7)水平及颗粒细胞中Ang受体的表达,探讨肾素-血管紧张系统(RAS)在PCOS发病中的作用。方法选取2011年11月—2013年11月河北医科大学第二医院生殖中心行体外受精/卵胞质内单精子注射-胚胎移植(IVF/ICSI-ET)治疗的女性89例,其中PCOS患者(PCOS组)66例,因双侧输卵管梗阻或者男方因素不孕的女性(对照组)23例。收集两组相关资料:体质指数(BMI),进入IVF/ICSI周期前基础血清卵泡刺激素(FSH)水平、促黄体生成素(LH)水平、雌二醇(E_2)水平、LH/FSH,降调后的血清FSH水平、LH水平、E_2水平、LH/FSH,控制性超排卵(COH)天数、注射人绒毛膜促性腺激素(HCG)日E_2水平,以及移植后受精数、卵裂数、可移植胚胎数、获卵数、妊娠率。移植后14 d测定血清β-HCG,移植后4周行B超检查,以判断妊娠与否,两组组内再分别分为妊娠亚组和未妊娠亚组。采用ELISA法测定卵泡液中AngⅡ、Ang-(1-7)水平,实时荧光定量PCR法检测颗粒细胞中AT1R、AT2R、MAS mRNA表达水平。结果 PCOS组BMI高于对照组(P<0.05);PCOS组基础血清FSH水平低于对照组,基础血清LH水平、LH/FSH高于对照组(P<0.05)。移植后,PCOS组受精数、卵裂数、可移植胚胎数多于对照组(P<0.05)。PCOS组卵泡液中AngⅡ、Ang-(1-7)水平高于对照组(P<0.05)。对照组内,妊娠亚组与未妊娠亚组卵泡液中AngⅡ、Ang-(1-7)水平比较,差异无统计学意义(P>0.05)。PCOS组内,妊娠亚组卵泡液中AngⅡ、Ang-(1-7)水平低于未妊娠亚组(P<0.05)。PCOS组颗粒细胞中AT1R、AT2R、MAS mRNA表达水平高于对照组(P<0.05)。结论 PCOS患者存在卵巢源性RAS亢进,AngⅡ、Ang-(1-7)可能在PCOS发生过程中起重要作用。Objective To detect the expression levels of Angiotensin（ Ang） Ⅱ and Ang-（ 1-7） in the follicular fluid and Ang receptors on granulosa cells in patients with polycystic ovary syndrome（ PCOS）,and to investigate the role of ovarian rennin-angiotensin system（ RAS） in the pathogenesis of PCOS. Methods From November 2011 to November 2013,89 female patients who received in vitro fertilization/intracytoplasmic sperm injection and embryo transfer（ IVF/ICSI-ET） treatment in the Reproductive Medicine Center of the Second Hospital of Hebei Medical University were selected,including 66 case of PCOS patients（ PCOS group） and 23 cases of infertility female patients due to bilateral fallopian tube obstruction or male factors（ control group）. The relevant data of two groups were collected： body mass index（ BMI）,basal serum follicle stimulating hormone（ FSH）,luteinizing hormone（ LH）,estradiol（ E_2） and LH/FSH before entering the IVF/ICSI cycles; the serum FSH,LH,E_2 and LH/FSH after down regulation; the day number of controlled ovarian hyperstimulation（ COH）; the levels of E_2 on the day of human chorionic gonadotropin（ HCG） injection; the numbers of fertilization, cleavage, transplantable embryos,eggs obtained and the rate of pregnancy after transplantation. The blood β-HCG was measured 14 days after transplantation. B type ultrasonography was performed 4 weeks after transplantation to determine whether the pregnancy occurred or not. The two groups were subdivided into pregnancy subgroup and non pregnancy subgroup. The levels of AngⅡ,Ang-（ 1-7） in human follicular fluid were determined by ELISA. The expression levels of mRNA of AT1R,AT2R,MAS in the granulosa cells were detected by Real-time PCR. Results The BMI of PCOS group was higher than that of control group（ P〈0.05）; the level of basal serum FSH in PCOS group was lower than that in control group,the basal serum LH level,LH/FSH in PCOS group were higher than those in control group（ P〈0.05）. After tran

关 键 词：多囊卵巢综合征 肾素-血管紧张系统 血管紧张素Ⅱ 

分 类 号：R711.75[医药卫生—妇产科学]