中药调周对薄型子宫内膜患者Wnt/β-catenin信号通路及临床妊娠结局的影响  

Effects of menstruation regulation with traditional Chinese medicine on the Wnt/β-catenin signaling pathway and clinical pregnancy outcomes in patients with thin endometrium

作　　者：李海霞[1] 夏正明[2] 苏宁[1] 彭娅娅[1] 王维[1] 罗小欢 蔡美虹 夏薇[1] LI Hai-xia;XIA Zheng-ming;SU Ning(Reproductive Medicine Center,Guangzhou First People's Hospital,Guangzhou 510180,China)

机构地区：[1]广州市第一人民医院生殖医学中心,510180 [2]广州医科大学附属第二医院,510000

出　　处：《中国现代药物应用》2023年第12期176-180,共5页Chinese Journal of Modern Drug Application

基　　金：广东省中医药局科研项目(项目编号:20221295),广州市卫生健康科技项目(项目编号:20211A011004)。

摘　　要：目的分析中药调周对薄型子宫内膜患者Wnt/β-连环蛋白(β-catenin)信号通路及临床妊娠结局的影响。方法选取进入冷冻胚胎移植(FET)周期的100例薄型子宫内膜患者,并将其随机分为中药调周组和对照组,每组50例,另选取同时期50例正常受试者作为正常组。三组均予激素替代治疗(HRT)方案准备内膜,中药调周组则在此基础上同时予中药调周。比较三组子宫内膜β-catenin、Integrinβ3表达;β-catenin、Integrinβ3 mRNA表达;β-catenin、Integrinβ3蛋白表达;比较对照组和中药调周组患者子宫内膜厚度、血流搏动指数(PI)、血流阻力指数(RI)、胚胎着床率(IR)和临床妊娠率(PR)。结果β-catenin主要在子宫内膜基质细胞中表达,Integrinβ3主要表达于子宫内膜腺上皮,免疫组化染色可见深浅不一的棕黄色颗粒沉淀。中药调周组子宫内膜β-catenin、Integrinβ3表达分别为(0.286±0.031)、(0.292±0.023),均高于对照组的(0.201±0.035)、(0.198±0.056),差异均具有统计学意义(P<0.05)。中药调周组患者子宫内膜β-catenin、Integrinβ3 mRNA表达分别为(0.498±0.047)、(0.591±0.026),均高于对照组的(0.176±0.036)、(0.218±0.075),差异均具有统计学意义(P<0.05)。中药调周组的子宫内膜β-catenin、Integrinβ3蛋白表达分别为(0.999±0.074)、(0.978±0.089),均高于对照组的(0.080±0.057)、(0.130±0.068),差异均具有统计学意义(P<0.05)。中药调周组与正常组子宫内膜β-catenin、Integrinβ3、β-catenin mRNA、Integrinβ3 mRNA、β-catenin蛋白、Integrinβ3蛋白表达比较,差异均无统计学意义(P>0.05)。中药调周组PI(1.43±0.32)、RI(0.74±0.31)均低于对照组的(1.87±0.12)、(0.96±0.21),子宫内膜厚度(8.97±1.23)mm厚于对照组的(7.60±0.51)mm,IR 36.00%(18/50)、PR 56.00%(28/50)高于对照组的12.00%(6/50)、24.00%(12/50),差异均具有统计学意义(P<0.05)。结论中药调周可增加β-catenin、Integrinβ3在黄体中期子宫内膜中的表达,Objective To analyze the effects of menstruation regulation with traditional Chinese medicine on the Wnt/β-catenin signaling pathway and clinical pregnancy outcomes in patients with thin endometrium.Methods A total of 100 patients with thin endometrium who entered the frozen-thawed embryo transfer(FET)cycle were randomly divided into a traditional Chinese medicine group and a control group,with 50 cases in each group;and another 50 cases who underwent FET at the same time were selected as normal group.Hormone replacement therapy(HRT)was used to prepare the endometrium in the above three groups,and the traditional Chinese medicine group received traditional Chinese medicine for menstruation regulation on this basis.The expression ofβ-catenin and Integrinβ3,mRNA expression ofβ-catenin and Integrinβ3,and protein expression ofβ-catenin and Integrinβ3 in the endometrium of the three groups was compared,as well as endometrial thickness,pulsatility index(PI),resistance index(RI),implantation rate(IR)and pregnancy rate(PR)between the control group and traditional Chinese medicine group.Resultsβ-catenin was mainly expressed in endometrial stromal cells,and Integrinβ3 was mainly expressed in endometrial glandular epithelium,and immunohistochemical staining showed varying shades of brownish-yellow granular precipitates.The expression ofβ-catenin and Integrinβ3 in the endometrium in the traditional Chinese medicine group were(0.286±0.031)and(0.292±0.023),which were higher than those of(0.201±0.035)and(0.198±0.056)in the control group,and the differences were statistically significant(P<0.05).The mRNA expression ofβ-catenin and Integrinβ3 in the Chinese medicine group were(0.498±0.047)and(0.591±0.026),which were higher than those of(0.176±0.036)and(0.218±0.075)in the control group,and all the differences were statistically significant(P<0.05).The mRNA expressions ofβ-catenin and Integrinβ3 in the traditional Chinese medicine group were(0.498±0.047)and(0.591±0.026),which were higher than those of(0.176

关 键 词：薄型子宫内膜 中药调周 妊娠结局 Wnt/β-连环蛋白信号通路 

分 类 号：R714.8[医药卫生—妇产科学]