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目的:探讨不明原因不孕患者黄体中期E-钙黏素在子宫内膜中的表达与同期血清性激素的相关性。方法:选择不明原因不孕患者45例,随机分为研究组30例(A组)、对照组15例(B组),另选正常生育妇女17例为正常对照组(C组)。A组排卵后第2日起注射黄体酮7d,用药2个周期,B、C组不作治疗。用免疫组化法检测A组治疗前后及B组、C组黄体中期子宫内膜E-钙黏素的表达;用放射免疫法检测3组同期血清E2、P4水平。结果:A、B组黄体中期E-钙黏素的表达及同期血清E2、P4、P4/E2均明显低于C组(P<0.01);E-钙黏素的表达与P4和E2均呈正相关,与P4/E2无相关性;A组治疗后E-钙黏素、P4和P4/E2均高于治疗前(P<0.01);A组治疗后妊娠率高于B组;当P4>40nmol/L妊娠率最高,且妊娠率随P4/E2增高而提高。结论:不明原因不孕患者黄体中期E-钙黏素表达缺陷、P4不足、P4/E2比例失调是影响子宫内膜容受性的重要原因。孕激素干预治疗对E-钙黏素的表达有调节作用。
Objective: To investigate the relationship between mid-luteal e-cadherin expression in endometrium and serum sex hormones in patients with unexplained infertility. Methods: Forty-five patients with unexplained infertility were randomly divided into study group (A group), control group (15 cases) and normal control group (17 cases) as normal control group (C group). In group A, progesterone was injected for 7 days from the second day after ovulation. Two cycles of treatment were used. Groups B and C were not treated. The expression of E-cadherin in mid-corpus luteum of group A before and after treatment, group B and group C was detected by immunohistochemistry. The serum levels of E2 and P4 were detected by radioimmunoassay in the same period. Results: The expression of E-cadherin and the levels of E2, P4 and P4 / E2 in the corpus luteum of group A and group B were significantly lower than those in group C (P <0.01). The expressions of E-cadherin and P4 and E2 were positive (P <0.01); The pregnancy rate of group A was higher than that of group B; when P4> 40nmol / L pregnancy rate was the highest, and the pregnancy rate increased with the increase of P4 / E2. CONCLUSION: In the unexplained infertility patients, the mid-corpus luteum e-cadherin expression is deficient, the P4 deficiency and P4 / E2 imbalance are the important reasons that affect the endometrial receptivity. Progesterone intervention regulates E-cadherin expression.