多囊卵巢综合征患者血清血管内皮生长因子、内皮抑素水平及对卵巢间质血流的影响研究

发布时间：2018-04-27 10:36

本文选题：多囊卵巢综合征 + 血管内皮生长因子类　；参考：《中国全科医学》2017年04期

【摘要】：目的探讨多囊卵巢综合征(PCOS)患者血清血管内皮生长因子(VEGF)、内皮抑素(ES)水平及对卵巢间质血流的影响。方法选取2014年7月—2015年9月在哈尔滨医科大学附属第二医院生殖中心就诊的PCOS患者96例作为PCOS组;选取同期因男方因素不孕而就诊于本院生殖中心的健康女性72例作为对照组。PCOS组根据稳态模型评价的胰岛素抵抗指数(HOMA-IR),分为PCOS胰岛素抵抗组(PCOS-IR组,n=47)和PCOS非胰岛素抵抗组(PCOS-NIR组,n=49)。采用酶联免疫吸附法测定所有受试者血清中的VEGF、ES水平。同时所有患者于卵泡早期应用经阴道彩色多普勒超声监测双侧卵巢间质血流,并计算出血流动力学参数:搏动指数(PI)和阻力指数(RI)。结果 PCOS-NIR、PCOS-IR组VEGF、ES水平高于对照组,PI、RI低于对照组,差异有统计学意义(P0.05);PCOS-IR组VEGF、ES水平高于PCOS-NIR组,PI、RI低于PCOS-NIR组,差异有统计学意义(P0.05)。PCOS患者VEGF水平与黄体生成素(LH)、睾酮(T)水平及LH/促卵泡刺激素(FSH)、HOMA-IR呈直线正相关(P0.05),与PI、RI呈直线负相关(P0.05);ES水平与LH、T水平及LH/FSH无直线相关性(P0.05),而与PI、RI呈直线负相关(P0.05),与HOMA-IR及VEGF水平呈直线正相关(P0.05)。PCOS患者PI、RI与LH、T水平及LH/FSH、HOMA-IR均呈直线负相关(P0.05)。多元线性回归分析结果显示,T、VEGF水平及HOMA-IR是PCOS患者PI的影响因素(P0.05);LH、T、VEGF水平及HOMA-IR是PCOS患者RI的影响因素(P0.05)。结论 VEGF、ES在PCOS患者血清中呈高表达,二者之间呈直线正相关且均与PCOS患者的HOMA-IR密切相关,同时VEGF的表达水平还与血清LH、T水平密切相关;VEGF与ES的表达失衡及HOMA-IR在PCOS卵巢间质血流异常增多中起主要作用。
[Abstract]:Objective to investigate the serum levels of vascular endothelial growth factor (VEGF) and endostatin (ESU) in patients with polycystic ovary syndrome (PCOS) and their effects on the interstitial blood flow. Methods from July 2014 to September 2015, 96 PCOS patients in the second affiliated Hospital of Harbin Medical University were selected as PCOS group. A total of 72 healthy women who were admitted to the reproductive center of our hospital during the same period because of male infertility were selected as the control group. PCOS group was divided into PCOS insulin resistance group (PCOS-IR group) and PCOS non-insulin resistance group (PCOS-NIR group) according to the steady-state model evaluation of insulin resistance index (HOMA-IRI). Enzyme-linked immunosorbent assay (Elisa) was used to determine the level of VEGF es in the serum of all subjects. At the same time, transvaginal color Doppler ultrasound was used to monitor bilateral ovarian interstitial blood flow in the early stage of follicle, and the blood flow parameters, pulsatility index (Pi) and resistance index (RI) were calculated. Results the level of VEGFN es in PCOS-NIR group was higher than that in control group, and the difference was significant (P 0.05). The level of VEGFN es in PCOS-IR group was higher than that in PCOS-NIR group, and that in PCOS-IR group was lower than that in PCOS-NIR group. There was a significant difference between VEGF level and luteinizing hormone (LH), testosterone (T), LH/ follicle stimulating hormone (FSH) and HOMA-IR in patients with P0.05. PCOS was positively correlated with P0.05, and had a linear negative correlation with P0.05s. There was no linear correlation between P0.05 and LH/FSH, but there was no linear correlation between P0.05 and Pi. 05. There was a linear negative correlation between Pi RI and LHT and LH / FSH HOMA-IR in patients with HOMA-IR and VEGF. There was a linear negative correlation between Pi RI and LH / FSHO HOMA-IR. The results of multiple linear regression analysis showed that HOMA-IR and HOMA-IR were the influential factors of Pi in patients with PCOS and HOMA-IR were the influential factors of RI in PCOS patients. Conclusion VEGFN es is highly expressed in the serum of PCOS patients, and there is a linear positive correlation between them and HOMA-IR in PCOS patients. At the same time, the expression level of VEGF was closely related to the level of serum LHH T. The imbalance of VEGF and es expression and HOMA-IR played a major role in the abnormal increase of interstitial blood flow in PCOS.
【作者单位】：哈尔滨医科大学附属第二医院妇产科;哈尔滨医科大学第二临床医学院;
【基金】：黑龙江省自然科学基金资助项目(H201392)
【分类号】：R711.75

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