不同卵巢储备患者促性腺激素受体表达及影响因素分析  

Expression of gonadotrophin receptor and influencing factors among different ovarian reserve patients

作　　者：何艺磊[1] 黄宁 胥晓飞 李蓉[1] 乔杰[1] He Yilei;Huang Ning;Xu Xiaofei;Li Rong;Qiao Jie(China Department of Obstetrics and Gynecology,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院妇产科,100191

出　　处：《中华生殖与避孕杂志》2018年第10期821-830,共10页Chinese Journal of Reproduction and Contraception

基　　金：国家自然科学基金面上项目(81771650;81471427)~~

摘　　要：目的探讨不同卵巢储备女性颗粒细胞促卵泡激素受体(FSHR)、促黄体生成素受体(LHR)mRNA相对表达水平与获卵情况的关系,以及与其他促排卵治疗过程中相关指标的影响。方法收集850例患者卵泡液及颗粒细胞。纳入患者分为卵巢功能正常组(n=419)、预期低反应组(n=255)、多囊卵巢综合征(PCOS)组(n=176)。采用反转录-实时定量PCR(qRT-PCR)法测定FSHR、LHR、抗苗勒管激素(AMH)及AMHⅡ型受体(AMHRⅡ) mRNA的表达,分析以上指标在不同卵巢储备患者中表达差异及影响因素。结果 (1) 3组患者在年龄、体质量指数(BMI)、窦卵泡数(AFC)、基础激素水平、用药情况、FSHR mRNA及获卵数等方面差异均有统计学意义(P<0.05)。(2) PCOS组促排卵后卵巢高反应患者FSHR mRNA表达量低于正常反应患者(P<0.05)。(3)对卵巢功能正常组患者FSHR mRNA主要与AMHmRNA(r=0.404,P<0.001)、LHR mRNA(r=0.388,P<0.001)呈正相关,预期低反应组患者FSHR mRNA主要与LHR(r=0.415,P<0.001)呈正相关,PCOS患者FSHR mRNA主要与AMHRⅡmRNA(r=0.311,P<0.001)呈正相关。结论不同卵巢储备患者促性腺激素(Gn)受体表达量存在差异,且Gn受体与AMHmRNA表达具有显著相关性,可能与卵巢储备异常发病机制相关,临床Gn用药可参考Gn受体表达情况进行选择。ObjectiveTo compare the relationship between the relative expression level of follicle stimulating hormone receptor （FSHR）, luteinizing hormone receptor （LHR） mRNA and oocyte retrieve outcomes, and to explore influencing factors in female granulosa cells with different ovarian reserves. MethodsFollicular fluid and granulosa cells of 850 women were collected, including normal ovarian function group （419 cases）, expected low ovarian response group （255 cases） and polycystic ovary syndrome （PCOS） group （176 cases）. The expression of FSHR, LHR, anti-Müllerian hormone （AMH） and AMH receptor （AMHR）Ⅱ mRNA were measured by quantitative Real-time polymerase chain reaction（qRT-PCR） and compared among different ovarian reserve patients. Influencing factors of these differentially expressed gonadotrophin （Gn） receptors were analyzed. Results1） There were significant differences in age, body mass index （BMI）, antral follicle count （AFC）, basal hormone level, medication, FSHR mRNA and number of oocytes retrieved among the three groups （P〈0.05）. 2） The expression of FSHR mRNA in high ovarian response PCOS patients was lower than that in normal response PCOS patients （P〈0.05）. 3） In the normal ovarian function group, FSHR mRNA mainly positively correlated with the expression of AMH mRNA （r=0.404, P〈0.001） and LHR mRNA （r=0.388, P〈0.001）. In expected low ovarian response group, FSHR mRNA mainly positively correlated with the expression of LHR mRNA （r=0.415, P〈0.001）. In PCOS group, FSHR mRNA mainly positively correlated with the expression of AMHRⅡ mRNA （r=0.311, P〈0.001）. ConclusionThe different expression of Gn receptor in patients with different ovarian reserve was observed, and the expression of Gn receptor had a significant correlation with AMH mRNA. This result could be related to the pathogenesis of abnormal ovarian reserve, and provided reference for the clinical Gn medication according to the expression of Gn receptors

关 键 词：卵巢储备 促卵泡激素受体(FSHR) 促黄体生成素受体(LHR) 抗苗勒管激素(AMH) 卵巢反应性 

分 类 号：R714.8[医药卫生—妇产科学]