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目的检测置铜节育器(IUD)妇女子宫内膜诱导型一氧化氮合酶(iNOS)、血管内皮生长因子(VEGF)、微血管密度(MVD)的表达及对内膜微血管生成的影响。方法收集60例要求取器妇女为研究对象,其中T CuIUD出血组20例、O CuIUD出血组20例、无出血组20例,与未置器组10例对照。取器时刮取内膜,采用半定量RT-PCR检测iNOSmRNA的表达,免疫组化SP法检测VEGF、MVD的表达。结果置器后iNOS mRNA、VEGF、MVD的表达均较置器前升高,出血组较无出血组升高,差异有统计学意义(P<0.05)。iNOS mRNA的表达在置T CuIUD出血组高于O CuIUD组,差异有统计学意义(P<0.05);VEGF的表达在置T CuIUD出血组与置O CuIUD出血组比较,差异无统计学意义(P>0.05)。VEGF与MVD在不同组别的表达呈正相关,相关系数r=0.625,差异有统计学意义(P<0.05),而iNOS mR-NA与MVD的表达无直线相关性。结论置CuIUD对内膜iNOS、VEGF、MVD的表达产生影响,两者的变化规律并不同步,但可能有一定关联,可能与对血管生成的影响环节和作用不同有关。
Objective To detect the expression of inducible nitric oxide synthase (iNOS), vascular endothelial growth factor (VEGF) and microvessel density (MVD) in endometrial tissue of women with IUD and its effect on endometrial microangiogenesis. Methods Totally 60 women were selected as study subjects. Among them, T CuIUD bleed group (20 cases), O CuIUD bleed group (20 cases), no bleed group (20 cases) and no intercourse group (10 cases). The endometrium was scraped when the device was removed, and the expression of iNOS mRNA was detected by semi-quantitative RT-PCR. The expression of VEGF and MVD was detected by immunohistochemical SP method. Results After placement, the expression of iNOS mRNA, VEGF and MVD were significantly increased compared with those before transplantation. There was a significant difference between the two groups (P <0.05). The expression of iNOS mRNA was higher in T CuIUD hemorrhage group than in O CuIUD group (P <0.05). There was no significant difference in the expression of VEGF between T CuIUD hemorrhage group and O CuIUD hemorrhage group (P < P> 0.05). There was a positive correlation between the expression of VEGF and MVD in different groups (r = 0.625, r = 0.625, P <0.05), while there was no linear correlation between the expression of mR-NA and MVD in iNOS. Conclusion The expression of CuIUD affects the expression of iNOS, VEGF and MVD in endometrium, and the changes of them are not synchronized, but may be related to angiogenesis.