论文部分内容阅读
目的探讨种植窗期子宫内膜自然杀伤细胞(uNK)对血管生成的影响及子宫动脉血流与胚胎种植的相关性。方法选择年龄小于35岁行体外受精-胚胎移植患者30例,检测种植窗期子宫动脉搏动指数,收集种植窗期子宫内膜,免疫组化SP法检测子宫内膜uNK细胞标记物CD56+、血管内皮细胞标记物F8因子及内膜血管平滑肌细胞标记物α-平滑肌肌动蛋白(αSMA)、重链肌球蛋白(SMM)的表达、定位。随访助孕结局,根据是否临床妊娠及至少有2次或2次以上的体外受精-胚胎移植助孕失败史,分为妊娠组和反复种植失败组。结果①uNK细胞的阳性表达率与F8因子的阳性表达率呈正相关(r=0.581,P<0.01)。②uNK细胞的阳性表达率与αSMA、SMM的阳性表达率呈正相关(r=0.572,r=0.569,P<0.01)。③反复种植失败组和妊娠组子宫动脉搏动指数分别为(0.85±1.51;0.93±0.24),差异无统计学意义(t=-0.98,P>0.05)。结论①人种植窗期子宫内膜uNK细胞与微血管密度、血管成熟度呈正相关,提示uNK细胞在种植窗期子宫内膜血管生成中起重要作用;②子宫动脉搏动指数对胚胎移植结局的影响,妊娠组和反复种植失败组之间无统计学差异,有待进一步探讨。
Objective To investigate the effects of uNK on the angiogenesis in implantation window and the correlation between uterine artery blood flow and embryo implantation. Methods Thirty patients with IVF - ET under the age of 35 were enrolled in this study. The pulsatility index of the uterine artery at implantation window was collected and the endometrium was harvested at the window of implantation. Immunohistochemical SP method was used to detect the expression of CD56 + Cell marker F8 factor and the expression and localization of α SMA and SMM in endometrial vascular smooth muscle cells. Follow-up pregnancy outcomes, according to whether the clinical pregnancy and at least 2 or more times in vitro fertilization-embryo transfer history of pregnancy failure, divided into pregnancy group and repeated implant failure group. Results ① The positive expression rate of uNK was positively correlated with the positive expression rate of F8 (r = 0.581, P <0.01). ② The positive expression rate of uNK cells was positively correlated with the positive expression rate of α SMA and SMM (r = 0.572, r = 0.569, P <0.01). ③ The pulsatility index of uterine artery in repeated implant failure group and pregnancy group were (0.85 ± 1.51; 0.93 ± 0.24), respectively, with no significant difference (t = -0.98, P> 0.05). Conclusion ① There is a positive correlation between uNK cells and microvessel density and vascular maturity in uterine endometrium during implantation, suggesting that uNK cells play an important role in endometrial angiogenesis at implantation window. (2) The effect of uterine arterial pulse index on embryo transfer outcome, There was no significant difference between pregnancy group and repeated implantation failure group, which needs to be further explored.