围排卵期应用左炔诺孕酮对着床期子宫内膜整合素表达的影响

目的:研究合成孕激素左炔诺孕酮对子宫内膜着床期整合素亚单位表达的影响。方法:20名妇女,随机分为两组,在LH-2日(LH-2组)或LH+2日(LH+2组)服用左炔诺孕酮0.75 mg/次,bid。每组妇女在服药周期前一个周期于LH-2日或LH+2日服用安慰剂,作为对照周期。两组均以超声波和尿LH峰检测确定服药日。每一周期均于LH+7日取子宫内膜标本。用整合素亚单位a1、a4、avb3抗体,以免疫组化和计算机图象分析方法检测和评价这些亚单位的表达。结果:两组在服用左炔诺酮后亚单位a1染色强度降低,但avb3无变化。亚单位a4在LH-2组明显降低,在LH+2组则差别不明显,而两组集合也是明显降低的。结论:妇女紧急避孕应用左炔诺酮后,其子宫内膜整合素亚单位a1和a4的表达与甾体激素的调控密切相关,有关机理尚需进一步研究。

Effect of Levonorgestrel Administrated Periovulatorily on Integrin Implantational Endometrium

Objective: To study the effects of synthetic progestogen levonorgestrel on integrin expressionin the endometrium. Methods: Twenty women were randomly allocated into two groups. Each woman waswere administrated at 12-hour抯 interval. Women took the tablets either on day LH-2 (LH-2 group) or on day LH+2(LH+2 group). The day of tablet administration was determined by ultrasound monitor and urinary LH surge. Inboth groups, endometrial biopsies were taken on day LH+7 each cycle. Antibodies against integrin subunits alpha 1,alpha 4 and alpha V beta 3 heterdimer were used to evaluate expression of those epitopes by immunohistochemistryand image analysis. Results: Levonorgestrel administration led to decrease of staining intensity of subunit a1, butnot of avb3, in both LH-2 and LH+2 groups. For subunit a4, there was significant decline in LH-2 group whereas noconsistent change was seen in LH+2 group due to divergence among subjects. Statistical evaluation of pooled LH-2 and LH+2 group indicates significant changes in subunit a1 and a4 staining while avb3 remains not significant.Conclusion: The endometrial expression of integrin subunit a1 and a4 are closely regulated by steroid hormone inwomen using emergency contraceptive levonorgestrel and the mechanism of this regulation remains to be determined.