CAJ | 학술논문

目的： Glycodelin-A是子宫内膜腺上皮细胞分泌的一种糖蛋白，其在胚胎着床以及植入期抑制母体对胚胎的免疫排斥反应、维持妊娠中发挥重要作用，并有望成为评价子宫内膜容受性、预测妊娠结局的一个重要指标。文中探讨宫腔内人工授精（ intrauterine insemination ， IUI）周期中，HCG日检测血清Glycodelin-A水平与子宫内膜容受性之间的关系及其对妊娠结局的影响。方法选择2012年10月至2014年2月在南京军区南京总医院生殖医学中心门诊就诊的女性患者共107例。纳入研究条件为接受IUI治疗且须双侧输卵管检查证实通畅，排除子宫内膜病变、子宫内膜息肉以及宫腔粘连。根据妊娠结局分为妊娠组和非妊娠组。采用ELISA方法检测IUI患者HCG日血清Glycodelin-A水平，化学发光免疫法检测血清雌二醇、孕酮、黄体生成素水平，同时经阴道超声评价子宫内膜情况。结果 HCG日妊娠组血清Glycodelin-A[（1．47±0．38） ng／mL]较未妊娠组血清[（0．62±0．13）ng／mL]显著升高（P＜0．05），子宫内膜厚度＜7 mm的患者较≥7 mm的患者HCG日血清Glycodelin-A水平显著降低[（0．51±0．17）ng／mL vs （1．53±0．49）ng／mL，P＜0．05]。结论 HCG日血清Glycodelin-A水平在一定程度上反映了子宫内膜的容受性，对IUI后妊娠结局的预测具有一定参考价值。
목적： Glycodelin-A시자궁내막선상피세포분비적일충당단백，기재배태착상이급식입기억제모체대배태적면역배척반응、유지임신중발휘중요작용，병유망성위평개자궁내막용수성、예측임신결국적일개중요지표。문중탐토궁강내인공수정（ intrauterine insemination ， IUI）주기중，HCG일검측혈청Glycodelin-A수평여자궁내막용수성지간적관계급기대임신결국적영향。방법선택2012년10월지2014년2월재남경군구남경총의원생식의학중심문진취진적녀성환자공107례。납입연구조건위접수IUI치료차수쌍측수란관검사증실통창，배제자궁내막병변、자궁내막식육이급궁강점련。근거임신결국분위임신조화비임신조。채용ELISA방법검측IUI환자HCG일혈청Glycodelin-A수평，화학발광면역법검측혈청자이순、잉동、황체생성소수평，동시경음도초성평개자궁내막정황。결과 HCG일임신조혈청Glycodelin-A[（1．47±0．38） ng／mL]교미임신조혈청[（0．62±0．13）ng／mL]현저승고（P＜0．05），자궁내막후도＜7 mm적환자교≥7 mm적환자HCG일혈청Glycodelin-A수평현저강저[（0．51±0．17）ng／mL vs （1．53±0．49）ng／mL，P＜0．05]。결론 HCG일혈청Glycodelin-A수평재일정정도상반영료자궁내막적용수성，대IUI후임신결국적예측구유일정삼고개치。
Objective Glycodelin-A is one of glycoproteins secreted from endometrial epithelial cells , and it plays an im-portant role in embryo implantation , inhibition of reject reaction and pregnancy maintenance .Glycodelin-A will become an important potential marker in evaluating the endometrial receptivity and predicting the pregnancy outcome .The aim of this study was to investigate the correlation of glycodelin-A detected on the day of HCG and endometrial receptivity and the effects of glycodelin -A on the pregnancy outcome in the intrauterine insemination (IUI) period. Methods One hundred and seven woman patients with bilateral unobstruct-ed tubes and without endometrial lesions , endometrial polyps or intrauterine adhesions from Oct 2012 to Feb 2014 in our hospital were recruited in this study .Serum glycodelin-A in women receiving IUI on the day of HCG was measured by ELISA .Serum estradiol (E2), progesterone (P), and corpus luteum (LH) levels were measured by immunochemiluminometric assays .The condition of the endometrium was examined by transvaginalultrasonography . Results The serum glycodelin-A level on the day of HCG was higher in pregnant group [(1.47 ±0.38)ng/mL] than that in nonpregnant group ([0.62 ±0.13]ng/mL).The serum glycodelin-A level on the day of HCG was higher in endometrial thickness ≥7 mm group ([1.53 ±0.49]ng/mL) than endometrial thickness <7 mm group ([0.51 ±0.17]ng/mL). Conclusion The serum glycodelin-A level on the day of HCG may reflect endometrial receptivity to a cer-tain extent , which might have prognosis value for pregnancy following IUI .