COX-2在多囊卵巢综合征患者子宫内膜的表达

目的:探讨环氧合酶-2(COX-2)在多囊卵巢综合征(PCOS)患者子宫内膜的表达及治疗后的变化。方法:选择PCOS患者(PCOS组)16例,另选择卵巢功能正常的不孕患者20例为对照组,PCOS组应用二甲双胍/达英-35治疗。所有病例均测体重指数(BMI),抽血测定女性激素六项并行75 g葡萄糖耐量试验(OGTT)和胰岛素释放试验(1RT)。于月经干净3～5天(闭经患者确认为卵泡期)刮取子宫内膜组织,采用免疫组织化学技术检测PCOS组治疗前后及对照组子宫内膜COX-2的表达。结果:PCOS组患者BMI\HOMA-IR、空腹胰岛素(I0)、75 g葡萄糖负荷后2 h胰岛素(I120)及T均明显高于家族史阴性患者(P均<0.01);PCOS组治疗前COX-2在子宫内膜的表达显著高于对照组(P<0.01),治疗后其表达明显下降(P<0.05)。结论:PCOS患者子宫内膜可能处于一种慢性炎症状态,子宫内膜COX-2过度表达可能是导致患者子宫内膜异常增生和不孕的原因之一,二甲双胍/达英-35可逆转此变化。

Expression of cyclooxygenase-2 in endometrium of cases with polycystic ovary syndrome

Objective:To explore the expression of cyclooxygenase-2(COX-2) in endometrium of patients with polycystic ovary syndrome(PCOS) and its change after treatment.Methods:16 cases with PCOS(PCOS group) and 20 infertile women with normal ovarian function(control group) were selected,the cases in PCOS group were treated with metformin/diane-35.Body mass index(BMI) was detected,blood samples were extracted to detect six kinds of sex hormones,75 g oral glucose tolerance test(OGTT) and insulin release test(IRT) were performed;the endometrial tissues were scraped at 3～5 days after menstruation was clean(at follicular phase for the cases with amenorrhea),immunohistochemical method was used to detect the expression levels of COX-2 in COS group(before and after therapy) and control group.Results:The levels of BMI/HOMA-IR,fasting insulin(I0),2-hour insulin after 75 g glucose load(I120) and testosterone in PCOS group were significantly higher than those in control group(P<0.01);the expression level of COX-2 in COS group(before therapy) was significantly higher than that in control group(P<0.01),after therapy,the expression level of COX-2 decreased significantly(P<0.05).Conclusion:Chronic inflammation maybe exist in endometrium of patients with PCOS,the over-expression of COX-2 may be an potential reason for abnormal hyperplasia of endometrium and infertility,metformin/diane-35 may inhibit the change.