胚胎培养液中表皮生长因子、转化生长因子、血管内皮生长因子与胚胎发育、妊娠结局的关系  

Relationship between epidermal growth factor, transforming growth factor,vascular endothelial growth factor in embryo culture medium and embryo development and pregnancy outcome

作　　者：曾彬[1] 苏兴[1] 崔静[1] 于婉莹[1] ZENG Bin;SU Xing;CUI Jing;YU Wangying(Department of Reproductive Medicine,Tangshan Maternal and Child Health Hospital,Tangshan,Hebei 063000,China)

机构地区：[1]唐山市妇幼保健院生殖医学科,河北唐山063000

出　　处：《安徽医药》2023年第10期2007-2011,共5页Anhui Medical and Pharmaceutical Journal

基　　金：2021年度河北省医学科学研究课题计划(20210396)。

摘　　要：目的分析胚胎培养液中表皮生长因子(EGF)、转化生长因子(TGF)、血管内皮生长因子(VEGF)与胚胎发育及体外受精-胚胎移植(IVF-ET)后妊娠结局的关系。方法选取2020年2月至2021年6月在唐山市妇幼保健院就诊并接受IVF-ET的92例病人为研究对象,根据妊娠结局将其分为妊娠组54例和非妊娠组38例;采用Wetzels胚胎评分系统进行胚胎评级,根据评分将胚胎分为Ⅰ级组、Ⅱ级组、Ⅲ级+Ⅳ级组。留取胚胎培养液,采用酶联免疫吸附(ELISA)法检测胚胎培养液中EGF、TGF-β1、VEGF表达水平;采用受试者操作特征(ROC)曲线分析胚胎培养液EGF、TGF-β1、VEGF水平对妊娠结局的预测价值;采用logistic回归分析影响IVF-ET后妊娠结局的因素。结果Ⅲ级+Ⅳ级组、Ⅱ级组、Ⅰ级组EGF[(0.46±0.19)、(1.14±0.21)、(2.68±0.81)μg/L]、TGF-β1[(58.72±15.13)、(80.68±19.12)、(98.74±23.75)ng/L]表达水平依次升高,VEGF[(39.66±12.71)、(22.85±4.79)、(13.86±3.32)ng/L]表达水平依次降低(P<0.05)。与妊娠组[(2.54±0.73)μg/L、(85.44±19.87)ng/L、(15.94±3.61)ng/L]相比,非妊娠组EGF[(1.49±0.43)μg/L]、TGF-β1[(60.42±15.76)ng/L]表达水平较低,VEGF[(24.75±7.94)ng/L]表达水平较高(P<0.05)。EGF、TGF-β1、VEGF水平及三者联合预测妊娠结局的曲线下面积(AUC)分别为0.88[95%CI:(0.78,0.97)]、0.88[95%CI:(0.78,0.98)]、0.81[95%CI:(0.68,0.95)]、0.96[95%CI:(0.90,1.00)],特异度分别为82.4%、82.4%、94.1%、88.2%,灵敏度分别为83.3%、94.4%、66.7%、96.4%。VEGF是IVF-ET后妊娠失败的独立危险因素(P<0.05),TGF-β1是IVF-ET后妊娠失败的保护因素(P<0.05)。结论胚胎培养液中EGF、TGF-β1、VEGF表达水平可能对评估胚胎质量及预测妊娠结局有重要价值。Objective To analyze the relationship between epidermal growth factor(EGF),transforming growth factor(TGF),vascular endothelial growth factor(VEGF)in embryo culture medium and embryo development and pregnancy outcome after in vitro fertilization-embryo transfer(IVF-ET).Methods Ninety-two patients who visited and received IVF-ET in Tangshan Maternal and Child Health Hospital from February 2020 to June 2021 were selected as the research objects.According to the pregnancy outcome,they were assigned into the pregnant group(54 cases)and the non-pregnant group(38 cases);the Wetzels embryo scoring system was used for embryo grading,and the embryos were divided into gradeⅠgroup,gradeⅡgroup,gradeⅢ+gradeⅣgroup according to the score.The embryo culture fluid was retained,and the enzyme-linked immunosorbent assay(ELISA)method was used to detect the expression levels of EGF,TGF-β1,and VEGF in the embryo culture fluid;receiver operating characteristic(ROC)curve was used to analyze the predictive value of EGF,TGF-β1,and VEGF levels in embryo culture fluid for pregnancy outcome;Logistic regression was used to analyze the affecting factors of pregnancy outcome after IVF-ET.Results The expression levels of EGF[(0.46±0.19),(1.14±0.21),(2.68±0.81)μg/L]and TGF-β1[(58.72±15.13),(80.68±19.12),(98.74±23.75)ng/L]in gradeⅢ+Ⅳgroup,gradeⅡgroup,and grade I group increased in turn,and the expression level of VEGF[(39.66±12.71),(22.85±4.79),(13.86±3.32)ng/L]decreased in turn(P<0.05).Compared with the pregnant group[EGF:(2.54±0.73)μg/L,TGF-β1:(85.44±19.87)ng/L,VEGF:(15.94±3.61)ng/L],the expression levels of EGF[(1.49±0.43)μg/L]and TGF-β1[(60.42±15.76)ng/L]in the non pregnant group were lower,while the expression levels of VEGF[(24.75±7.94)ng/L]were higher(P<0.05).The area under the curve(AUC)of EGF,TGF-β1,VEGF levels and the combination of the three predicting pregnancy outcome was 0.88[95%CI:(0.78,0.97)],0.88[95%CI:(0.78,0.98)],0.81[95%CI:(0.68,0.95)],0.96[95%CI:(0.90,1.00)],respectively,the specificity wa

关 键 词：胚胎移植 体外受精 表皮生长因子 转化生长因子 血管内皮生长因子类 胚胎发育 妊娠结局 

分 类 号：R714.8[医药卫生—妇产科学]