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目的探讨人薄型子宫内膜种植窗期血管生成状态及雌、孕激素受体、整合素β3表达的变化和意义。方法选择2003年9月至2004年9月于遵义医学院附属医院生殖中心就诊的自然月经周期尿黄体生成素(LH)峰日子宫内膜厚度<8mm不孕妇女25例为研究对象,同期8mm<子宫内膜厚度<16mm的不孕妇女25例作为正常对照,采用化学发光法、免疫组织化学技术分别检测两组黄体中期血清雌二醇(E2)、孕酮(P)以及子宫内膜雌激素受体(ER)、孕激素受体(PR)、整合素β3和微血管密度(MVD)。结果两组血清E2、P水平及子宫内膜ER、PR的表达强度比较差异无显著性意义(P>0.05);研究组MVD及整合素β3的表达均明显低于对照组(P<0.01);两组MVD与整合素β3的表达均存在正相关关系(分别为r=0.916,P<0.01;r=0.956,P<0.01)。结论种植窗期子宫内膜血管生成不良和整合素β3的低表达可能是薄型子宫内膜不孕患者胚胎种植率低下的一个原因。
Objective To investigate the changes and significance of the expression of integrin β3 and estrogen and progesterone receptors at the implantation window in human thin endometrium. Methods From September 2003 to September 2004 at the Zunyi Medical College Affiliated Hospital Reproductive Center for treatment of natural menstrual cycle urinary LH (endometrial thickness) <8mm infertile women 25 cases of the same period, the same period 8mm <25 cases of endometrial thickness <16mm infertile women as normal control, using chemiluminescence, immunohistochemical techniques were measured mid-luteal phase serum estradiol (E2), progesterone (P) and endometrial Hormone receptor (ER), progesterone receptor (PR), integrin beta 3 and microvessel density (MVD). Results There was no significant difference in the levels of E2 and P and the expression of ER and PR in the two groups (P> 0.05). The expression of MVD and integrin β3 in the study group were significantly lower than those in the control group (P <0.01) There was a positive correlation between MVD and integrin β3 expression in the two groups (r = 0.916, P <0.01; r = 0.956, P <0.01). Conclusion Poor endometrial angiogenesis and low expression of integrin β3 during implantation may be one of the reasons for the low embryo implantation rate in patients with thin endometrial infertility.