子宫内膜异位症患者卵泡液、卵泡刺激素骨形态发生蛋白-15对颗粒细胞增殖及孕酮分泌的影响  

The effect of follicular fluid from patients with endometriosis, follicle stimulating hormone and bone morphogenetic protein 15 on the proliferation and progesterone secretion of granular cells

作　　者：王秀芬 林小娜[1] 戴永东[1] 林翔 吕慧敏 周枫[1] 张松英[1] 

机构地区：[1]浙江大学医学院附属邵逸夫医院妇产科,杭州310016 [2]山西医学科学院山西大医院妇产科

出　　处：《中华医学杂志》2017年第45期3543-3547,共5页National Medical Journal of China

基　　金：国家自然科学基金青年项目（81402131）;浙江省自然科学基金项目（Y2080505）;浙江省自然科学基金项目（LY151-1040004）

摘　　要：目的探讨子宫内膜异位症（以下简称内异症）患者卵泡液、卵泡刺激素（FSH）及骨形态发生蛋白－15（BMP－15）对离体培养的人黄素化颗粒细胞增殖及其孕酮分泌的影响。方法取因管性/男方因素不孕行体外受精－胚胎移植（IVF－ET）患者促排卵后取卵日卵丘颗粒细胞。对照组用全DMEM/F－12培养液培养，试验组用分别加入12 μg/L卵泡刺激素（FSH），为FSH组、6 μg/L BMP－15（BMP－15组）、5%管性/男方因素不孕患者卵泡液（管性组）、5%内异症因素不孕患者卵泡液（内异组）、5%内异症因素不孕患者卵泡液＋12 μg/L FSH（内异＋FSH组）、5%内异症因素不孕患者卵泡液＋6 μg/L BMP－15（内异＋BMP－15组）的DMEM/F－12培养液培养。48 h后用血球计数法观察细胞的生长速度，采用化学发光法检测培养上清液孕酮的水平。结果与对照组比，FSH组细胞增殖增加，内异组及内异＋BMP15组细胞增殖受抑制，差异均有统计学意义。与对照组比FSH组、管性组及内异组的颗粒细胞培养上清液的孕酮水平显著升高。内异组与管性组比孕酮分泌降低；在内异组中加入FSH（内异＋FSH组）后，孕酮分泌水平比对照组及单纯内异组显著增加，加入BMP－15（内异＋ BMP－15组）后，孕酮分泌水平比对照组增加，与单纯内异组差异无统计学意义。结论FSH可以促进颗粒细胞的增殖及孕酮分泌功能，BMP－15对颗粒细胞的增殖及孕酮分泌功能无明显影响。内异症患者卵泡液对颗粒细胞的增殖及孕酮分泌均有抑制作用，FSH可以逆转其抑制作用，BMP－15不能改变内异症患者卵泡液的作用结局。ObjectiveThe study was designed to evaluate the effect of follicular fluid from patients with endometriosis, follicle stimulating hormone （FSH）, bone morphogenetic protein 15 （BMP-15） on the proliferation and progesterone secretion of human luteinized granular cells in vitro.MethodsCumulus granulosa cells were collected from the patients who underwent in vitro fertilization and embryo transfer （IVF-ET） ovulation due to tubal or male factor infertility on the day of the retrieval. The cells in the control group were cultured with complete medium of DMEM/F-12, an extra of FSH at a dose of 12 μg/L was added in the FSH group, an extra of BMP-15 at a dose of 6 μg/L was added to the BMP-15 group, an extra of 5% of the follicular fluid from the patients with tubal or male factor infertility was added to the tubal group, an extra of 5% of the follicular fluid from the patients with endometriosis infertility was added to the endometriosis group, an extra of 5% of the follicular fluid from the patients with endometriosis infertility plus FSH at a dose of 12 μg/L were added to the endometriosis plus FSH group, and an extra of 5% of the follicular fluid from the patients with endometriosis infertility plus BMP-15 at a dose of 6 μg/L were added to the endometriosis plus BMP-15 group. Hemacytometer counting method was used to observe the growth of cells after 48 hours, and chemiluminescence method was utilized to measure the level of progesterone in culture supernatant.ResultsThe cell proliferation was enhanced in the FSH group, while the proliferation was inhibited in the endometriosis group and the endometriosis plus BMP-15 group, compared to the control group, both of which, were statistically significant. Compared to the control group, the progesterone levels from the culture supernatant of granular cells were significantly elevated in the FSH group, tubal group and endometriosis group. The secretion of progesterone in the endometriosis group was lower than that in the tubal group. After addition of FSH int

关 键 词：子宫内膜异位症 卵泡液 卵泡刺激素 骨形态发生蛋白-15 

分 类 号：R711.71[医药卫生—妇产科学]