【摘要】：目的研究生長激素受體(GHR)、雌激素受體(ER)、孕激素受體(PR)在宮腔粘連(研究組)和非宮腔粘連(對照組)患者子宮內(nèi)膜組織中的表達(dá)情況,為宮腔粘連患者在經(jīng)陰道宮腔鏡下宮腔粘連分離術(shù)(TCRA)術(shù)后使用生長激素、雌激素、孕激素預(yù)防再粘連提供一定的理論參考。方法1、資料來源研究組:2013年11月至2014年05月在我院婦科行宮腔鏡檢查并確診為宮腔粘連患者28例為研究組,年齡20~35歲,平均年齡29.62±2.52歲。對照組:同期因其他原因(不孕、子宮縱膈或節(jié)育器嵌頓)在宮腔鏡檢查下確診為非宮腔粘連患者22例為對照組,年齡21~40歲,平均年齡26.80±3.34歲。并且這些非宮腔粘連患者既往都有宮腔操作史。2、實(shí)驗(yàn)方法2.1標(biāo)本采集。研究組:患者均行宮腔鏡檢查確診為宮腔粘連,在宮腔鏡檢查中或經(jīng)陰道宮腔鏡下宮腔粘連分離術(shù)操作過程中,視需要在尚殘存的正常子宮內(nèi)膜組織中,用異物鉗鉗取適量(質(zhì)量約20 mg)的內(nèi)膜組織作為標(biāo)本。對照組:患者因其他原因行宮腔鏡檢查確認(rèn)為非宮腔粘連且既往都有過宮腔操作史,如子宮縱膈、不孕或節(jié)育器嵌頓,按需要鉗取適量正常子宮內(nèi)膜組織。2.2實(shí)驗(yàn)方法。采用免疫組化Max Vision兩步法和實(shí)時熒光定量PCR(q RTPCR)方法分別檢測兩組患者子宮內(nèi)膜組織中GHR蛋白、ER蛋白、PR蛋白和GHRm RNA、ERm RNA、PR m RNA的表達(dá)情況。結(jié)果1、免疫組化Max Vision兩步法檢測研究組和對照組ER蛋白、PR蛋白、GHR蛋白表達(dá);實(shí)時熒光定量PCR實(shí)驗(yàn)方法檢測研究組和對照組ERm RNA、PRm RNA、GHRm RNA表達(dá);兩種實(shí)驗(yàn)方法檢測GHR、ER在兩組中表達(dá)有顯著統(tǒng)計學(xué)意義(P0.05),PR在兩組中表達(dá)無統(tǒng)計學(xué)意義(P0.05)。2.采用免疫組化Max Vision兩步法檢測子宮內(nèi)膜腺體與子宮內(nèi)膜間質(zhì)中ER、PR和GHR蛋白表達(dá),兩部位比較差異有統(tǒng)計學(xué)意義(P0.05)。結(jié)論1.研究組患者子宮內(nèi)膜組織中的GHR表達(dá)低于對照組,而且這種表達(dá)在兩組子宮內(nèi)膜腺體中較多,而在兩組子宮內(nèi)膜間質(zhì)中表達(dá)較少,為宮腔粘連患者在TCRA術(shù)后使用生長激素預(yù)防再粘連提供一定的理論參考。2.研究組患者子宮內(nèi)膜組織中ER表達(dá)高于對照組,PR表達(dá)在兩組之間無差異;ER、PR在兩組子宮內(nèi)膜腺體中表達(dá)較多,而在兩組子宮內(nèi)膜間質(zhì)中表達(dá)較少甚至不表達(dá);為宮腔粘連患者在TCRA術(shù)后使用雌激素和孕激素預(yù)防再粘連提供一定的理論參考。
[Abstract]:Objective to study the expression of growth hormone receptor (GHR), estrogen receptor (ER), progesterone receptor (PR) in endometrium of patients with intrauterine adhesions (study group) and non-uterine adhesions (control group). To provide a theoretical reference for the prevention of adhesions by growth hormone, estrogen and progesterone in patients with intrauterine adhesions after (TCRA) under transvaginal hysteroscopy. Methods 1. Data source study group: from November 2013 to May 2014, 28 patients with intrauterine adhesion were diagnosed by hysteroscopy in our hospital. The age was 2035 years old with an average age of 29.62 鹵2.52 years. Control group: 22 cases of non-uterine adhesions diagnosed by hysteroscopy for other reasons (infertility, uterine mediastinal or IUD incarceration) were the control group. The average age was 26.80 鹵3.34 years. And these patients with non-uterine adhesions had a history of intrauterine operations of. 2. 2 and 2. 1 specimens were collected. Study group: all the patients underwent hysteroscopy to diagnose intrauterine adhesions, and during hysteroscopy or vaginal hysteroscopy, in the normal endometrial tissues which remained as needed during the operation of hysteroscopy or vaginal hysteroscopy, The appropriate amount of intimal tissue (about 20 mg mass) was obtained by using foreign body forceps. Control group: the patients were confirmed by hysteroscopy as non-intrauterine adhesions for other reasons and had previous history of uterine cavity operation, such as mediastinal uterus, infertility or incarceration of sterility or device, and appropriate amount of normal endometrial tissue .2.2 was obtained according to the need of forceps. The expression of GHR protein ER protein, PR protein and GHRm RNA,ERm RNA,PR m RNA in endometrium of two groups were detected by immunohistochemical Max Vision two-step method and real-time fluorescence quantitative PCR (q RTPCR) method. Results 1. The expression of ER protein and PR protein in study group and control group were detected by immunohistochemical Max Vision two-step method, and the expression of ERm RNA,PRm RNA,GHRm RNA in study group and control group was detected by real-time fluorescence quantitative PCR assay. Two experimental methods to detect the expression of GHR,ER in the two groups had significant statistical significance (P0.05) the expression of PR in the two groups had no statistical significance (P0.05). 2. The expression of ER,PR and GHR in endometrium and endometrial stroma was detected by immunohistochemical Max Vision two-step method. The difference between the two sites was statistically significant (P0.05). Conclusion 1. The expression of GHR in endometrial tissue of study group was lower than that in control group, and the expression was more in endometrial gland and less in stroma of endometrium in both groups. To provide a theoretical reference for the patients with intrauterine adhesion after TCRA to use growth hormone to prevent re-adhesion. 2. The expression of ER in endometrial tissue of study group was higher than that of control group. There was no difference between the two groups in the expression of ERP in the endometrial gland of the two groups, but there was little or no expression in the stroma of endometrium in the two groups. To provide a theoretical reference for the use of estrogen and progesterone in patients with intrauterine adhesion after TCRA.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R711.74

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