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首页> 中文期刊> 《中国全科医学》 >血管紧张素Ⅱ和血管紧张素1-7及其受体在多囊卵巢综合征患者中的表达研究

血管紧张素Ⅱ和血管紧张素1-7及其受体在多囊卵巢综合征患者中的表达研究

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Objective To detect the expression levels of Angiotensin(Ang)Ⅱ and Ang-(1-7)in the follicular fluid and Ang receptors on granulosa cells in patients with polycystic ovary syndrome(PCOS),and to investigate the role of ovarian rennin-angiotensin system(RAS) in the pathogenesis of PCOS.Methods From November 2011 to November 2013,89 female patients who received in vitro fertilization/intracytoplasmic sperm injection and embryo transfer(IVF/ICSI-ET)treatment in the Reproductive Medicine Center of the Second Hospital of Hebei Medical University were selected,including 66 case of PCOS patients(PCOS group) and 23 cases of infertility female patients due to bilateral fallopian tube obstruction or male factors(control group).The relevant data of two groups were collected:body mass index(BMI),basal serum follicle stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2) and LH/FSH before entering the IVF/ICSI cycles;the serum FSH,LH,E2 and LH/FSH after down regulation;the day number of controlled ovarian hyperstimulation(COH);the levels of E2 on the day of human chorionic gonadotropin(HCG) injection;the numbers of fertilization,cleavage,transplantable embryos,eggs obtained and the rate of pregnancy after transplantation.The blood β-HCG was measured 14 days after transplantation.B type ultrasonography was performed 4 weeks after transplantation to determine whether the pregnancy occurred or not.The two groups were subdivided into pregnancy subgroup and non pregnancy subgroup.The levels of AngⅡ,Ang-(1-7) in human follicular fluid were determined by ELISA.The expression levels of mRNA of AT1R,AT2R,MAS in the granulosa cells were detected by Real-time PCR.Results The BMI of PCOS group was higher than that of control group(P<0.05);the level of basal serum FSH in PCOS group was lower than that in control group,the basal serum LH level,LH/FSH in PCOS group were higher than those in control group(P<0.05).After transplantation,the numbers of fertilization,cleavage,transplantable embryos in PCOS group were more than those in control group(P<0.05).The levels of AngⅡ and Ang-(1-7) in follicular fluid on the day of follicular aspiration in PCOS group were higher than those in control group(P<0.05).In control group,there were no statistically significant differences in the levels of AngⅡ and Ang-(1-7) in follicular fluid between pregnancy subgroup and non pregnancy subgroup(P>0.05).In PCOS group,the levels of AngⅡ and Ang-(1-7) in follicular fluid in the pregnancy subgroup were lower than those in non pregnancy subgroup(P<0.05).The expression levels of AT1R mRNA,AT2R mRNA,MAS mRNA in granulosa cells of PCOS group were significantly higher than those of control group(P<0.05).Conclusion The ovarian RAS hyperfunction exists in PCOS patients,the AngⅡ and Ang-(1-7) might play an important role in the pathogenesis of PCOS.%目的 检测多囊卵巢综合征(PCOS)患者卵泡液中血管紧张素(Ang)Ⅱ、Ang-(1-7)水平及颗粒细胞中Ang受体的表达,探讨肾素-血管紧张系统(RAS)在PCOS发病中的作用.方法 选取2011年11月-2013年11月河北医科大学第二医院生殖中心行体外受精/卵胞质内单精子注射-胚胎移植(IVF/ICSI-ET)治疗的女性89例,其中PCOS患者(PCOS组)66例,因双侧输卵管梗阻或者男方因素不孕的女性(对照组)23例.收集两组相关资料:体质指数(BMI),进入IVF/ICSI周期前基础血清卵泡刺激素(FSH)水平、促黄体生成素(LH)水平、雌二醇(E2)水平、LH/FSH,降调后的血清FSH水平、LH水平、E2水平、LH/FSH,控制性超排卵(COH)天数、注射人绒毛膜促性腺激素(HCG)日E2水平,以及移植后受精数、卵裂数、可移植胚胎数、获卵数、妊娠率.移植后14 d测定血清β-HCG,移植后4周行B超检查,以判断妊娠与否,两组组内再分别分为妊娠亚组和未妊娠亚组.采用ELISA法测定卵泡液中AngⅡ、Ang-(1-7)水平,实时荧光定量PCR法检测颗粒细胞中AT1R、AT2R、MAS mRNA表达水平.结果 PCOS组BMI高于对照组(P<0.05);PCOS组基础血清FSH水平低于对照组,基础血清LH水平、LH/FSH高于对照组(P<0.05).移植后,PCOS组受精数、卵裂数、可移植胚胎数多于对照组(P<0.05).PCOS组卵泡液中AngⅡ、Ang-(1-7)水平高于对照组(P<0.05).对照组内,妊娠亚组与未妊娠亚组卵泡液中AngⅡ、Ang-(1-7)水平比较,差异无统计学意义(P>0.05).PCOS组内,妊娠亚组卵泡液中AngⅡ、Ang-(1-7)水平低于未妊娠亚组(P<0.05).PCOS组颗粒细胞中AT1R、AT2R、MAS mRNA表达水平高于对照组(P<0.05).结论 PCOS患者存在卵巢源性RAS亢进,AngⅡ、Ang-(1-7)可能在PCOS发生过程中起重要作用.

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