米非司酮紧急避孕机制的研究

目的:探讨米非司酮(Mifepristone,孕激素受体拮抗剂)对月经不同功能时期中Ley寡糖蛋白表达的影响。方法:取34例患子宫肌瘤志愿者手术后的内膜,经病理检测,分为4组:增生期(8例)、分泌期(8例)、分泌期服用米非司酮(8例)及增生期服用米非司酮(10例),每例均重复实验。应用Western免疫印迹法,观察Ley寡糖抗原的表达。结果:①每组样品中Ley寡糖蛋白均有4种分子量68kD、60kD、52kD、27kD表达;②分析结果显示:Ley寡糖在分泌期高表达,增生期表达低,两组间差异有显著性(P<0.001);③分泌期服用米非司酮的表达较分泌期明显减少(P<0.001),较增生期无明显变化(P>0.05);④增生期服用米非司酮的表达较增生期有所增多(P<0.001),仍较分泌期明显减少(P<0.001)。结论:在分泌期Ley寡糖蛋白的含量呈高表达,在月经不同功能时期服用米非司酮后,Ley寡糖蛋白表达均较分泌期明显减少。提示人子宫内膜Ley寡糖蛋白的表达可能与胚泡着床密切相关,并且米非司酮可能是通过减少Ley寡糖蛋白的表达而达到紧急避孕的目的。

Study of Mechanism of Mifepristone in Emergency Contraception

Objective: To study the effect of mifepristone on the expression of Lewis Y oligosaccharide protein during various stages of menstrual cycle.Methods:34 samples were taken from the endomeytium of patients with leiomyoma after hysterectomy and confirmed by pathological examination. Samples were divided into four groups: proliferators phase 8 cases; secretary phase 8 cases; secretary phase with mifepristone administration 8 cases and proliferators phase with mifepristone administration 10 cases.The samples were examined delicately to investigated the expression of LeY oligosaccharide by Western blot analysis.Results: The results showed that①the LeY carry protein in those samples of every group had 4 bound with molecular weight of 68kD, 60kD 52kD and 27kD;②the result showed that the expression of LeY was significantly increased from proliferators phase to secretary phase (P<0.001);③in the secretary phase with mifepristone administration the expression was decreased dramatically (P<0.001), while no obvious alteration compared with proliferators phase;④in proliferators phase with mifepristone administration , the expression was obviously higher than that of proliferators phase (P<0.001), but still significantly decreased than that of secretary phase(P<0.001).Conclusion:The secretary phase LeY oligosaccharide protein was high expression, while during various function stage of menstrual cycle with mifepristone administration, LeY oligosaccharide protein expression were obviously decreased than secretary phase. It is indicated that the expression of LeY oligosaccharide protein in human endometrium might be closely related to the blast cyst implantation, and the effects of mifepristone on emergency contraception were attained by decreasing LeY oligosaccharide protein expression.