临床和实验医学杂志
臨床和實驗醫學雜誌
림상화실험의학잡지
JOURNAL OF CLINICAL AND EXPERIMENTAL MEDICINE
2014年
24期
2033-2037
,共5页
多囊卵巢综合征%子宫内膜%甾体激素受体%肥胖%高雄激素血症
多囊卵巢綜閤徵%子宮內膜%甾體激素受體%肥胖%高雄激素血癥
다낭란소종합정%자궁내막%치체격소수체%비반%고웅격소혈증
Polycystic ovary syndrome%Endometria%Steroid receptors%Obesity%Hyperandrogenism
目的：检测多囊卵巢综合征（ PCOS）患者子宫内膜雌激素α、β受体（ ER α、β）、孕激素受体（ PR）、雄激素受体（AR）的表达，探讨其与PCOS患者性激素、血脂、胰岛素抵抗指数（HOMA）、体重指数（BMI）等临床特征的关系。方法选取PCOS患者31例作为实验组，输卵管性不孕患者20例作为对照组。对比PCOS患者与对照组年龄、BMI、血脂、性激素、HOMA和子宫内膜甾体激素受体表达情况。且PCOS患者按照肥胖与否、胰岛素抵抗正常与否和睾酮高低分组。采用免疫组化方法检测各组子宫内膜ERα、ERβ、PR、AR表达。通过相关性分析PCOS组子宫内膜ERα、ERβ、PR、AR与血清雌激素水平的关系。结果 PCOS组和对照组年龄、BMI、血脂差异无统计学意义；PCOS组睾酮、雌激素、HOMA-IR高于对照组。PCOS组子宫内膜腺体及间质的ERα、ERβ、PR、AR表达均高于对照组；但两组的ERα/ ERβ表达差异无统计学意义。PCOS高睾酮组与正常睾酮组除AR外其余各甾体激素受体在子宫内膜腺体和间质的表达均差异无统计学意义；PCOS高睾酮组腺体AR表达高于正常睾酮组。高睾酮组ERα、ERβ、PR、AR表达高于对照组；正常睾酮组ERα、PR、AR在腺体和间质的表达及腺体ERβ表达高于对照组。PCOS肥胖组和非肥胖组ERα、ERβ、PR、AR在子宫内膜腺体及间质中的表达均高于对照组。但肥胖组与非肥胖组ERα、ERβ、ERα/ERβ、PR、AR表达差异无统计学意义。PCOS胰岛素抵抗组与非胰岛素抵抗组ERα、ERβ、ERα/ERβ、PR、AR表达差异无统计学意义。胰岛素抵抗组ERα、ERβ、PR、AR 、腺体ERα/ERβ表达高于对照组。非胰岛素抵抗ERα、PR、AR、腺体ERβ表达高于对照组。相关性分析发现PCOS组子宫内膜间质ERα、PR、ERα/ERβ表达与血清雌激素水平呈正相关；腺体ERα/ERβ、AR、PR表达与血清雌激素水平呈正相关。腺体ERβ的表达与血清雌激素水平呈负相关。腺体AR表达与血脂中的胆固醇（ CHO）、高密度脂蛋白（ HDL）、载脂蛋白B（ APO-B）水平呈正相关。结论 PCOS患者子宫内膜甾体激素受体表达高于正常妇女，除ERβ外其他甾体激素受体表达与PCOS血清雌激素水平呈正相关，ERβ与雌激素水平呈负相关。高雄激素血症、高脂血症可以增强PCOS患者子宫内膜AR表达。
目的：檢測多囊卵巢綜閤徵（ PCOS）患者子宮內膜雌激素α、β受體（ ER α、β）、孕激素受體（ PR）、雄激素受體（AR）的錶達，探討其與PCOS患者性激素、血脂、胰島素牴抗指數（HOMA）、體重指數（BMI）等臨床特徵的關繫。方法選取PCOS患者31例作為實驗組，輸卵管性不孕患者20例作為對照組。對比PCOS患者與對照組年齡、BMI、血脂、性激素、HOMA和子宮內膜甾體激素受體錶達情況。且PCOS患者按照肥胖與否、胰島素牴抗正常與否和睪酮高低分組。採用免疫組化方法檢測各組子宮內膜ERα、ERβ、PR、AR錶達。通過相關性分析PCOS組子宮內膜ERα、ERβ、PR、AR與血清雌激素水平的關繫。結果 PCOS組和對照組年齡、BMI、血脂差異無統計學意義；PCOS組睪酮、雌激素、HOMA-IR高于對照組。PCOS組子宮內膜腺體及間質的ERα、ERβ、PR、AR錶達均高于對照組；但兩組的ERα/ ERβ錶達差異無統計學意義。PCOS高睪酮組與正常睪酮組除AR外其餘各甾體激素受體在子宮內膜腺體和間質的錶達均差異無統計學意義；PCOS高睪酮組腺體AR錶達高于正常睪酮組。高睪酮組ERα、ERβ、PR、AR錶達高于對照組；正常睪酮組ERα、PR、AR在腺體和間質的錶達及腺體ERβ錶達高于對照組。PCOS肥胖組和非肥胖組ERα、ERβ、PR、AR在子宮內膜腺體及間質中的錶達均高于對照組。但肥胖組與非肥胖組ERα、ERβ、ERα/ERβ、PR、AR錶達差異無統計學意義。PCOS胰島素牴抗組與非胰島素牴抗組ERα、ERβ、ERα/ERβ、PR、AR錶達差異無統計學意義。胰島素牴抗組ERα、ERβ、PR、AR 、腺體ERα/ERβ錶達高于對照組。非胰島素牴抗ERα、PR、AR、腺體ERβ錶達高于對照組。相關性分析髮現PCOS組子宮內膜間質ERα、PR、ERα/ERβ錶達與血清雌激素水平呈正相關；腺體ERα/ERβ、AR、PR錶達與血清雌激素水平呈正相關。腺體ERβ的錶達與血清雌激素水平呈負相關。腺體AR錶達與血脂中的膽固醇（ CHO）、高密度脂蛋白（ HDL）、載脂蛋白B（ APO-B）水平呈正相關。結論 PCOS患者子宮內膜甾體激素受體錶達高于正常婦女，除ERβ外其他甾體激素受體錶達與PCOS血清雌激素水平呈正相關，ERβ與雌激素水平呈負相關。高雄激素血癥、高脂血癥可以增彊PCOS患者子宮內膜AR錶達。
목적：검측다낭란소종합정（ PCOS）환자자궁내막자격소α、β수체（ ER α、β）、잉격소수체（ PR）、웅격소수체（AR）적표체，탐토기여PCOS환자성격소、혈지、이도소저항지수（HOMA）、체중지수（BMI）등림상특정적관계。방법선취PCOS환자31례작위실험조，수란관성불잉환자20례작위대조조。대비PCOS환자여대조조년령、BMI、혈지、성격소、HOMA화자궁내막치체격소수체표체정황。차PCOS환자안조비반여부、이도소저항정상여부화고동고저분조。채용면역조화방법검측각조자궁내막ERα、ERβ、PR、AR표체。통과상관성분석PCOS조자궁내막ERα、ERβ、PR、AR여혈청자격소수평적관계。결과 PCOS조화대조조년령、BMI、혈지차이무통계학의의；PCOS조고동、자격소、HOMA-IR고우대조조。PCOS조자궁내막선체급간질적ERα、ERβ、PR、AR표체균고우대조조；단량조적ERα/ ERβ표체차이무통계학의의。PCOS고고동조여정상고동조제AR외기여각치체격소수체재자궁내막선체화간질적표체균차이무통계학의의；PCOS고고동조선체AR표체고우정상고동조。고고동조ERα、ERβ、PR、AR표체고우대조조；정상고동조ERα、PR、AR재선체화간질적표체급선체ERβ표체고우대조조。PCOS비반조화비비반조ERα、ERβ、PR、AR재자궁내막선체급간질중적표체균고우대조조。단비반조여비비반조ERα、ERβ、ERα/ERβ、PR、AR표체차이무통계학의의。PCOS이도소저항조여비이도소저항조ERα、ERβ、ERα/ERβ、PR、AR표체차이무통계학의의。이도소저항조ERα、ERβ、PR、AR 、선체ERα/ERβ표체고우대조조。비이도소저항ERα、PR、AR、선체ERβ표체고우대조조。상관성분석발현PCOS조자궁내막간질ERα、PR、ERα/ERβ표체여혈청자격소수평정정상관；선체ERα/ERβ、AR、PR표체여혈청자격소수평정정상관。선체ERβ적표체여혈청자격소수평정부상관。선체AR표체여혈지중적담고순（ CHO）、고밀도지단백（ HDL）、재지단백B（ APO-B）수평정정상관。결론 PCOS환자자궁내막치체격소수체표체고우정상부녀，제ERβ외기타치체격소수체표체여PCOS혈청자격소수평정정상관，ERβ여자격소수평정부상관。고웅격소혈증、고지혈증가이증강PCOS환자자궁내막AR표체。
Objective To evaluate the expression of steroid receptors( estrogen receptor α,estrogen receptor β,progesterone receptor, androgen receptor,ERα,ERβ,PR,AR),in endometria of polycystic ovary syndrome( PCOS). To study the correlation between the the expres-sion of steroid receptors in the endometria and the clinical features of polycystic ovary syndrome. Methods Case-control study was used to 31 pa-tients with PCOS and 20 healthy women . Immunohistochemistry was used in expression studies of ERα,ERβ,PR,AR. Insulin and glucose lev-els of serum( OGTT,INS)were measured using RIA and glucose oxidase test,respectively. A fasting blood sample was drawn for plasma hormone profile ,lipid and lipoprotein profile. Results The expression of ERα、ERβ、PR、AR in the endometria of PCOS was higher than in the control group. The expression of AR was higher in PCOS with hyperandrogenemia than in PCOS with normal androgenemia and control group. The expres-sion of AR was higher in PCOS with hyperandrogenemia than in PCOS with normal androgenemia and control group. The expression of ERα,ERβ, PR,AR was higher in PCOS with hyperandrogenemia than in PCOS with control group. The expression of ERα、PR、AR and ERβin intercellular substance was higher in PCOS with low testosterone levels than control group. The expression of ERα、ERβ、PR、AR was higher in obese and not obese PCOS with than control group. But,the expression of ERα,ERβ,PR,AR in the obese and not obese PCOS was no difference. The expres-sion of ERα、ERβ、PR、AR was higher in obese and not obese PCOS with than control group. But,the expression of ERα,ERβ,ERα/ERβ,PR, AR in the hyperinsulinemia and non-insulin resistance PCOS was no difference. The expression of ERα,ERβ,PR,AR and ERα/ERβin gland was higher in PCOS with non-insulin resistance PCOS than control group. Hyperinsulinemia and obesity were not associated with expression of ERα,ERβ,PR,AR. Person correlation analyze found plasma estradiol(E2)level was related with ERα、PR、ERα/ERβ、AR. AR was related with cholesterol( CHO),high density lipoprotein( HDL),apolipoprotein B( APO-B). Conclusion The expression of steroid hormones recep-tors was higher in endometria of untreated PCOS than in the control group. Plasma E2 level was related to expression of steroid hormones receptors. However hyperinsulinemia and obesity were not associated with them. AR was related to lipid and lipoprotein profile.
