PCOS患者卵泡液中血管紧张素Ⅱ-1型受体自身抗体与卵泡发育的关系研究  

Relationship between angiotensinⅡtype 1 receptor autoantibody levels in follicular fluid and follicular development in patients with PCOS

作　　者：喻亚娜 宋德 杨贵芳 陈耀 张熤楠 李雪敏 周佳慧 史裕晖 杨晓丽[1] Yu Yana;Song De;Yang Guifang;Chen Yao;Zhang Yinan;Li Xuemin;Zhou Jiahui;Shi Yuhui;Yang Xiaoli(Taiyuan Central Hospital Assisted Reproduction Center,Taiyuan 030000,China;Taiyuan Central Hospital,Reproductive Immunity and Heredity Departments and Cities Jointly Build Key Laboratory Training Bases of Shanxi Province,Taiyuan 030000,China;Fenyang College of Shanxi Medical University,Fenyang 032200,China)

机构地区：[1]太原市中心医院辅助生殖中心,太原030000 [2]太原市中心医院生殖免疫与遗传厅市共建山西省重点实验室培育基地,太原030000 [3]山西医科大学汾阳学院,汾阳032200

出　　处：《中华生殖与避孕杂志》2024年第9期922-929,共8页Chinese Journal of Reproduction and Contraception

基　　金：国家区域医疗中心科技创新计划项目(202202,202238,202261);山西省基础研究计划项目(202203021222413,202303021221247);山西省应用基础研究项目(202303021211111);太原市“六个一批”卫生健康人才能力提升专项行动科研项目(Z2022002,Y2023001)。

摘　　要：目的:探讨多囊卵巢综合征(polycystic ovary syndrome,PCOS)不孕患者卵泡液中血管紧张素Ⅱ-1型受体自身抗体(angiotensinⅡtype 1 receptor autoantibodies,AT1-AA)水平与卵泡发育的相关性。方法:选取2021年6月至2022年10月期间太原市中心医院辅助生殖中心行体外受精/卵胞质内单精子注射-胚胎移植(in vitro fertilization/intracytoplasmic sperm injection and embryo transfer,IVF/ICSI-ET)助孕的不孕患者182例进行病例对照研究,其中因输卵管因素所致不孕患者80例,记为输卵管因素组,PCOS患者102例,记为PCOS组。分别比较两组患者的一般资料、促排卵指标及胚胎实验室指标;采用酶联免疫吸附方法(enzyme-linked immunosorbent assay,ELISA)检测取卵日卵泡液中AT1-AA的水平,Pearson或Spearman分析AT1-AA水平和卵泡发育指标之间的相关性,应用多元线性回归调整干扰因素后分析AT1-AA与胚胎实验室指标的相关性。结果:PCOS组体质量指数[body mass index,BMI,(25.29±3.25)kg/m 2]、窦卵泡计数[antral follicle count,AFC,24.00(17.00,24.00)]、基础血清睾酮[0.50(0.36,0.79)μg/L]、抗苗勒管激素[anti-Müllerian hormone,AMH,4.92(2.57,8.28)μg/L]水平均显著高于输卵管因素组[(23.01±2.92)kg/m 2,P<0.001;15.00(10.25,19.00),P<0.001;0.38(0.20,0.59)μg/L,P=0.019;3.06(2.19,4.89)μg/L,P=0.006];并且PCOS组卵泡液中AT1-AA P/N值[4.24(2.07,8.89)]显著高于输卵管因素组[2.96(1.86,4.84),P=0.027]。另外,PCOS组初潮年龄[13.00(12.00,14.00)岁]早于输卵管因素组[14.00(13.00,15.00)岁,P=0.007],催乳素水平[12.09(9.65,16.64)μg/L]低于输卵管因素组[16.27(12.86,20.94)μg/L,P=0.002],两组其余指标差异均无统计学意义(均P>0.05)。相关性分析结果显示PCOS患者卵泡液中AT1-AA水平与获卵率呈负相关(r=-0.159,P=0.019)。多元线性回归分析结果显示,在调整混杂因素后,卵泡液中AT1-AA水平与获卵率及正常受精率呈负相关(β=-0.598,P=0.028;β=-0.527,P=0.022)。结论:PCOS患者卵泡ObjectiveTo investigate the presence of angiotensinⅡtype 1 receptor autoantibodies(AT1-AA)in follicular fluid,and to investigate the correlation between AT1-AA levels and follicular development in follicular fluid of infertile patients with polycystic ovary syndrome(PCOS).MethodsA case-control study was conducted on 182 infertile patients who underwent in vitro fertilization/intracytoplasmic sperm injection and embryo transfer(IVF/ICSI-ET)at the Center for Reproductive Medicine of Taiyuan Central Hospital from June 2021 to October 2022.There were 80 cases in the fallopian tube factor group(tubal factor group)and 102 cases in PCOS infertility group(PCOS group).Univariate analysis was performed for the general data,ovulation induction indexes and embryonic laboratory indexes of the two groups.Enzyme-linked immunosorbent assay(ELISA)was used to detect the level of AT1-AA in follicular fluid on the day of oocyte retrieval.Pearson or Spearman was used to analyze the correlation between AT1-AA level and follicle development indexes,and multiple linear regression was used to adjust for interfering factors to analyze the correlation between AT1-AA level and embryonic laboratory indicators.ResultsBody mass index[BMI,(25.29±3.25)kg/m 2],antral follicle count[AFC,24.00(17.00,24.00)],basal serum teststerone[0.50(0.36,0.79)μg/L]and anti-Müllerian hormone[AMH,4.92(2.57,8.28)μg/L]in PCOS group were significantly higher than those in tubal factor group[(23.01±2.92)kg/m 2,P<0.001;15.00(10.25,19.00),P<0.001;0.38(0.20,0.59)μg/L,P=0.019;3.06(2.19,4.89)μg/L,P=0.006].Moreover,the AT1-AA P/N value in follicular fluid in PCOS group[4.24(2.07,8.89)]was significantly higher than that in tubal factor group[2.96(1.86,4.84),P=0.027].In addition,the age of menarche in PCOS group[13.00(12.00,14.00)years]was earlier than that in tubal factor group[14.00(13.00,15.00)years,P=0.007].Prolactin level[12.09(9.65,16.64)μg/L]was lower than that of tubal factor group[16.27(12.86,20.94)μg/L,P=0.002],and there were no statistical differences in

关 键 词：多囊卵巢综合征 卵泡液 血管紧张素Ⅱ-1型受体自身抗体 卵泡发育 

分 类 号：R714.8[医药卫生—妇产科学]