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运用透射电镜观察多囊卵巢综合征(PCOS)组及正常妇女组卵泡的形态,用体视学方法测量两组各级卵泡基底膜的厚度。结果显示:两组原始卵泡的基底膜厚度相似,但随着卵泡的发育卵泡基底膜逐渐增厚,PCOS组增厚更明显,对照组初级卵泡基底膜的平均厚度是0 293±0 204μm,PCOS组是0 463±0 287μm,两组比较有统计学差异(P<0 05)。对照组次级卵泡基底膜的平均厚度为0 542±0 298μm,PCOS组为1 234±0 345μm,两组比较有统计学差异(P<0 05)。两组原始卵泡的前颗粒细胞的超微结构相似,随着卵泡的发育,PCOS组的颗粒细胞内参与蛋白质合成的细胞器明显较对照组丰富;正常组窦前卵泡的颗粒细胞出现分化现象,PCOS组却未见分化现象。结果提示:PCOS患者卵泡基底膜屏障的增厚可能使卵泡刺激素FSH进入卵泡困难,颗粒细胞不能正常分化,“FSH 颗粒细胞轴”功能低下,导致不孕症。
Transmission electron microscopy was used to observe the morphology of follicles in PCOS group and normal women. The thickness of follicular basement membrane was measured by stereological method. The results showed that the thickness of basal lamina of primordial follicles was similar in both groups, but thickening of follicular basal lamina was more obvious with the development of follicles. The thickening of PCOS group was more obvious. The average thickness of basal lamina of primary follicles in control group was 0 293 ± 0 204μm, PCOS Group is 0 463 ± 0 287μm, the two groups were statistically significant (P <0 05). The average thickness of the secondary follicle in the control group was 0 542 ± 0 298 μm, while the PCOS group was 1 234 ± 0 345 μm. There was significant difference between the two groups (P <0.05). The ultrastructures of pregranular granulosa cells in two groups of primordial follicles were similar. With the development of follicles, the organelles involved in protein synthesis in granulosa cells of PCOS group were significantly more abundant than those in control group. The granulosa cells of normal follicles showed differentiation, PCOS Group did not see the phenomenon of differentiation. The results suggest that the thickening of follicular basement membrane barrier in patients with PCOS may lead to the follicle stimulating hormone FSH into the follicle difficult, granulosa cells can not normal differentiation, “FSH granulosa cell axis ” dysfunction, leading to infertility.