糖耐量试验正常的多囊卵巢综合征患者子宫内膜胰岛素及其受体表达的研究

目的 :了解糖耐量正常的多囊卵巢综合征 (PCOS)患者子宫内膜局部胰岛素水平及其受体表达的情况 ,以了解它们在多囊卵巢综合征发病中的作用。方法 :采用免疫组化方法对口服葡萄糖耐量试验 (OGTT)正常的PCOS患者子宫内膜石蜡标本进行研究。结果 :PCOS的子宫内膜大部分腺体发育均达到增殖中晚期的发育程度 ,其局部胰岛素水平及其受体表达均显著高于增殖早期对照组 (P <0 .0 1) ;其胰岛素水平与增殖中晚期对照组差异无显著性 (P >0 .0 5) ;PCOS组胰岛素受体表达则低于增殖晚期组 ,差异有显著性 (P <0 .0 5) ;增殖晚期对照组与增殖早中期对照组相比胰岛素及其受体差异有显著性(P <0 .0 1)。结论 :糖耐量试验正常的PCOS患者子宫内膜可能依然存在胰岛素抵抗现象 ,这种子宫内膜的胰岛素抵抗可能影响子宫内膜发育 ,因此 ,可能是PCOS妊娠率低及受孕后流产率高的原因之一。

Study of insulin concentration and its receptor expression on endometrium of polycystic ovary syndrome with normal level of OGTT

Objective:To study the insulin level and the expression of its receptor on the endometrium of polycystic ovary syndrome with normal level OGTT and discuss the possible mechanism of lower pregnant rate and higher rate of abortion of PCOS.Methods:The level of insulin and its receptor in endometrium was detected by immunohistochemical method using mouse monoclonal antibody against insulin and its receptor.Results: The levels of insulin and its receptor in endometrium of PCOS group were significantly higher than those of early-proliferate phase (P<0.01); and those in endometrium of mid-late proliferate phase were also significantly higher than those of early-proliferate phase(P<0.01). The level of insulin in endometrium of PCOS was not significantly lower than that of mid-late proliferate phase(P>0.05);but its receptor was significantly lower than that of mid-late proliferate phase(P<0.05).In addition,positive stainings were mainly observed in the glandular cells of the endometrium and located in membrane and plasma of cells. Conclusions:Insulin resistance also lies in the endometrium of PCOS with normal OGTT(Oral Glucose Tolerance Test).This possibly is the reason of the low rate of pregnant and high rate of abortion.