地屈孕酮对多囊卵巢综合征妊娠大鼠种植窗期PR、ICAM-1的影响-东南大学学报医学版

地屈孕酮对多囊卵巢综合征妊娠大鼠种植窗期PR、ICAM-1的影响

单位：1. 南京中医药大学, 江苏南京 210023;
2. 武警南京医院, 江苏南京 210028

分类号：R-33;R711.75

出版年·卷·期（页码）：2016·35·第四期（514-518）

摘要：

目的：探讨多囊卵巢综合征（PCOS）大鼠低着床率的可能原因及地屈孕酮在种植窗期的作用机制。方法：80日龄始正常大鼠以生理盐水（NS）、PCOS模型大鼠以克罗米芬（CC）连续灌胃5 d后分别与雄鼠合笼，选取妊娠大鼠随机分为A组（正常妊娠组）、B组（PCOS妊娠组）、C组（PCOS妊娠加地屈孕酮组）3组。于妊娠第5天各组大鼠以酶联免疫吸附法（ELISA）测定雌二醇（E2）、孕酮（P）、肿瘤坏死因子（TNF-α）表达水平，免疫组化法测定右侧子宫内膜孕激素受体（PR）、细胞间黏附分子（ICAM-1）表达水平。结果：种植窗期E2、TNF-α表达B、C组高于A组（P<0.05，P<0.01），P表达C、A组高于B组（P<0.05，P<0.01），E2/P值3组间差异显著（P<0.05，P<0.01），PR表达B组低于A组（P<0.05），ICAM-1表达B组低于A、C组（P<0.05）；PR与E2、P、E2/P值均无相关性（P>0.05），ICAM-1与P呈正相关（P<0.05），TNF-α与E2/P值呈负相关。结论：PCOS大鼠低着床率可能与性激素、TNF-α水平异常及低PR、ICAM-1有关；地屈孕酮可能通过调整P、E2/P值，上调ICAM-1、PR表达，改善卵巢功能及子宫内膜容受性，提高胚胎着床率。

Objective:To investigate the possible reasons for low rate of implantation in rats with polycystic ovarian syndrome (PCOS) and the influence mechanism of dydrogesterone on implantation rate of PCOS rats. Methods:From the 80th day after birth, normal rats were given normal saline (NS) and PCOS rats model were given clomiphene (CC) for five consecutive days. Then they were mated with male rats. The pregnant rats were selected and divided into three groups with 6 in each group:group A (normal pregnant rats); group B (PCOS pregnant rats); group C (PCOS pregnant rats with dydrogesterone).On the 5th day of pregnancy, the levels of E2, P and TNF-α in each group were determined by ELISA, and the expression levels of progesterone receptor (PR) and intercellular adhesion molecule-1(ICAM-1) in endometrium were detected by immunohistochemistry. Results:In planting window period, the levels of E2 and TNF-α in group B and C were higher than those in group A (P<0.05, P<0.01);the levels of P in group A and C were higher than those in group B (P<0.05, P<0.01). The values of E2/P in the three groups were significantly different (P<0.05, P<0.01).The expression of PR in group B was lower than that in group A (P<0.05), and ICAM-1 expression levels in group B were lower than those in group A and C (P<0.05). PR expression had no correlation with E2, P and E2/P (P>0.05).ICAM-1 was positively correlated with P, while TNF-α was negatively correlated with E2/P. Conclusion:Low rate of implantation in PCOS pregnant rats was probably associated with abnormal sex hormone levels, TNF-α and decreased expression of PR and ICAM-1.Dydrogesterone can possibly improve the rate of implantation through adjusting P and E2/P, upregulating ICAM-1 and PR expression, and improving ovarian function and the receptivity of endometrium.

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