本文選題：多囊卵巢綜合征　切入點：自噬　出處：《河北醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:探究多囊卵巢綜合征與非多囊卵巢綜合征患者放射冠及卵丘顆粒細(xì)胞(冠丘顆粒細(xì)胞)中自噬相關(guān)基因Beclin1 m RNA和Atg5 m RNA的表達(dá)是否存在差異及其意義,為研究多囊卵巢綜合征(Polycystic Ovarian Syndrome,PCOS)發(fā)生、發(fā)展中潛在的分子機(jī)制提供新線索。方法:對照組入組標(biāo)準(zhǔn):女方年齡35歲;月經(jīng)規(guī)律;主要因男方因素要求行卵胞漿內(nèi)單精子顯微注射(Intracytoplasmic sperm injection,ICSI)助孕;無盆腔手術(shù)史;無子宮內(nèi)膜異位癥;且術(shù)前檢查各項指標(biāo)均無異常;無煙酒嗜好吸毒史。多囊卵巢綜合征組入組標(biāo)準(zhǔn)(根據(jù)2003年鹿特丹標(biāo)準(zhǔn)):女方年齡35歲;主要因男方因素要求行ICSI助孕;無盆腔手術(shù)史;無子宮內(nèi)膜異位癥;且術(shù)前檢查各項指標(biāo)均無異常;無煙酒嗜好吸毒史;稀發(fā)排卵或無排卵;超聲表現(xiàn)為雙側(cè)卵巢有12個以上直徑為2-9mm卵泡;有或無高雄激素的臨床表現(xiàn)和(或)高雄激素血癥(除外其他高雄激素疾病)。按以上入組標(biāo)準(zhǔn)收取2016年3月1日至2016年6月30日于河北醫(yī)科大學(xué)第二醫(yī)院生殖醫(yī)學(xué)科首次接受助孕且新鮮周期可移植的患者,多囊卵巢綜合征患者組17例和對照組25例廢棄的冠丘顆粒細(xì)胞及相應(yīng)患者的臨床資料:年齡,身體質(zhì)量指數(shù)(Body Mass Index,BMI),促排方案,扳機(jī)日血清促黃體生成素(Luteotropic hormone,LH)、雌性激素(Estrogen,E2)、孕激素(Progesterone,P),獲卵數(shù),受精率,是否妊娠(移植后28天經(jīng)陰道超聲提示宮內(nèi)孕,并探及胚芽及心管搏動視為妊娠)。用Real-Time PCR(Polymerase Chain Reaction)測定冠丘顆粒細(xì)胞中Beclin1 m RNA和Atg5 m RNA的表達(dá),根據(jù)熒光定量原始檢測結(jié)果,按照2-△△ct相對定量計算公式計算出各樣品的目的基因相對定量結(jié)果。用SPSS 17.0統(tǒng)計學(xué)分析軟件進(jìn)行數(shù)據(jù)處理。符合正態(tài)分布的計量資料用均數(shù)±標(biāo)準(zhǔn)差表示,不符合正態(tài)分布的計量資料用中位數(shù)(四分位數(shù)間距)表示;符合正態(tài)分布且方差齊的兩樣本比較用t檢驗,不符合正態(tài)分布的兩樣本比較用秩和檢驗;計數(shù)資料的比較用X2檢驗;兩資料均為正態(tài)分布的相關(guān)采用Pearson相關(guān),不滿足條件者采用Spearman秩相關(guān)分析。以上均以P0.05為差異有統(tǒng)計學(xué)意義。結(jié)果:1 Beclin1 m RNA和Atg5 m RNA在兩組中均有表達(dá)。Beclin1 m RNA和Atg5 m RNA在多囊卵巢綜合征組的相對表達(dá)量分別是1.612±1.068和0.990(0.96),其中Beclin1 m RNA在多囊卵巢綜合征組的表達(dá)量高于對照組,差異有統(tǒng)計學(xué)意義(P0.05)。2將兩組患者的臨床資料(BMI,扳機(jī)日血清LH、E2、P,獲卵數(shù),受精率,妊娠情況)進(jìn)行分析。與對照組相比,多囊卵巢綜合征組BMI值25.048±3.557高于對照組22.660(3.580),且有統(tǒng)計學(xué)差異(P0.05);扳機(jī)日血清LH在對照組和多囊卵巢綜合征組的統(tǒng)計結(jié)果分別為1.910(1.140)、1.190(0.620),且在對照組表現(xiàn)出相對高水平,此差異有統(tǒng)計學(xué)意義(P0.05);兩組妊娠率(妊娠例數(shù)/該組總例數(shù))的比較,對照組為15/25,多囊卵巢綜合征組為4/17,對照組妊娠率高于多囊卵巢綜合征組,差異有統(tǒng)計學(xué)意義(P0.05)。扳機(jī)日血清E2、P,獲卵數(shù)、受精率兩組資料無統(tǒng)計學(xué)差異(P0.05)。用Pearson相關(guān)分別分析Beclin1 m RNA的表達(dá)與多囊卵巢綜合征組中BMI、血清P值、受精率之間的相關(guān)性;用Spearman秩相關(guān)分別分析Beclin1 m RNA的表達(dá)與多囊卵巢綜合征組中血清LH值、血清E2值、獲卵數(shù)之間的相關(guān)性。研究顯示Beclin1 m RNA的表達(dá)與多囊卵巢綜合征組中BMI、獲卵數(shù)的相關(guān)系數(shù)分別為ρ=0.332、r=0.310,均有正相關(guān)關(guān)系,但是均無統(tǒng)計學(xué)意義(P0.05);Beclin1 m RNA的表達(dá)與多囊卵巢綜合征組中其他臨床資料無相關(guān)性。比較19例妊娠者與23例非妊娠者Beclin1 m RNA和Atg5 m RNA的表達(dá)情況,在非妊娠組中兩基因表達(dá)活性較高,且Beclin1 m RNA在兩組中表達(dá)差異有統(tǒng)計學(xué)意義(P0.05)。結(jié)論:1 Beclin1 m RNA和Atg5 m RNA在兩組中均有表達(dá),提示細(xì)胞自噬普遍存在于冠丘顆粒細(xì)胞中。2 Beclin1 m RNA在兩組之間的表達(dá)差異有統(tǒng)計學(xué)意義(P0.05),且在多囊卵巢綜合征組的表達(dá)量高于對照組,可從一個方面提示多囊卵巢綜合征組的自噬活性高于對照組,推測顆粒細(xì)胞可通過增強(qiáng)自噬活性,對抗和修復(fù)卵巢微環(huán)境變化所帶來的損傷。3 Beclin1和Atg5分別在自噬體啟動形成、延伸中起重要作用。Beclin1 m RNA在兩組之間的表達(dá)差異有統(tǒng)計學(xué)意義(P0.05),Atg5m RNA在兩組之間的表達(dá)無統(tǒng)計學(xué)差異(P0.05),表明PCOS患者冠丘顆粒細(xì)胞自噬活性改變及過程,仍需要大樣本和后續(xù)研究的進(jìn)一步支持。4 多囊卵巢綜合征組冠丘顆粒細(xì)胞自噬活性增加與BMI,扳機(jī)日血清LH、E2、P關(guān)系不密切,即以上臨床資料并不是影響冠丘顆粒細(xì)胞自噬活性改變的主要因素,也不是通過影響冠丘顆粒細(xì)胞自噬活性導(dǎo)致該組妊娠率降低。5 妊娠與非妊娠之間的比較,自噬活性存在差異,且非妊娠組自噬活性較高,仍需進(jìn)行更多臨床資料分析,尋找自噬活性存在差異的原因。6 PCOS患者高雄激素、血糖、血脂、空腹胰島素、是否存在煙霧暴露等是否會影響冠丘顆粒細(xì)胞自噬過程,是否會通過改變冠丘顆粒細(xì)胞自噬而影響卵子質(zhì)量進(jìn)而影響妊娠率仍需進(jìn)一步討論及驗證。7 PCOS與PCO患者中冠丘顆粒細(xì)胞自噬情況是否有差異,亦需要進(jìn)一步探索。8 本文討論冠丘顆粒細(xì)胞自噬與PCOS的關(guān)系,對PCOS發(fā)生、發(fā)展中潛在的分子機(jī)制研究提供了新思路,但是仍有較多亟待研究討論的問題需要去探索。
[Abstract]:Objective: To explore the polycystic ovary syndrome in patients with polycystic ovary syndrome and non coronal radiation and cumulus cells (Corona cumulus granulosa cells) whether the expression of autophagy related gene Beclin1 m RNA and Atg5 m RNA the difference and significance of polycystic ovary syndrome (Polycystic Ovarian Syndrome, PCOS), provide new clues to the molecular in the development of potential mechanism. Methods: control group group: the woman 35 years of age; menstrual regularity; mainly due to male factors required for intracytoplasmic sperm injection (Intracytoplasmic sperm, injection, ICSI) of pregnancy; no history of pelvic surgery; without endometriosis; and preoperative indicators examination no abnormal; no smoking and drinking history of drug abuse. Patients enrolled PCOS (according to 2003 Rotterdam standard): the age of 35 years; the main factors for the man asked for ICSI help pregnant; no history of pelvic surgery; no Endometriosis; and the preoperative indicators were no exception; no smoking and drinking history of drug abuse; dilute ovulation or anovulation; ultrasound showed bilateral ovaries with more than 12 2-9mm diameter follicles; clinical and performance with or without hormone (or Kaohsiung) Kaohsiung hormones (except other hormone Kaohsiung disease) according to the above standard charge into the group. From March 1, 2016 to June 30, 2016 in the second hospital of Hebei Medical University Department of reproductive medicine for the first time and the fresh cycle can help pregnant transplant patients, patients with polycystic ovary syndrome group and control group of 17 cases of clinical data of 25 cases of granular cell and Crown Hill abandoned the corresponding patients: age, body mass index (Body, Mass Index, BMI), cupai scheme, the trigger on serum luteinizing hormone (Luteotropic, hormone, LH), female sex hormones (Estrogen, E2), progesterone (Progesterone, P), the number of oocytes, fertilization rate, pregnancy (transplantation After 28 days of vaginal ultrasound tip intrauterine pregnancy, and to explore and germ and heart beat as pregnancy). Real-Time PCR (Polymerase Chain Reaction) expression in granulosa cells of Beclin1 m Crown Hill RNA Atg5 and m RNA assay, fluorescence quantitative detection based on the original results, according to the 2- delta CT relative quantitative calculation formula to calculate the target gene of each sample relative quantitative results. The data were analyzed using SPSS 17 statistical analysis software. With normal distribution measurement data is represented by the standard deviation, does not conform to the normal distribution of the measurement data with the median (four percentile interval); accord with normal distribution and homogeneity of two samples with t test does not meet the normal distribution of two samples compared with rank test; compared with count data X2 test; two normal distribution data are related to the use of Pearson, does not meet the conditions by using Spearman rank correlation The analysis above is P0.05. The difference was statistically significant. Results: there were two groups in the expression of 1 Beclin1 m RNA and Atg5 m RNA.Beclin1 m and Atg5 RNA relative expression of M RNA in polycystic ovary syndrome group were 1.612 + 1.068 and 0.990 (0.96), the Beclin1 m RNA in PCOS the expression of syndrome group than in the control group, the difference was statistically significant (P0.05.2) clinical data of the two groups (BMI, LH, serum E2, trigger, P, number of oocytes, fertilization rate, pregnancy) were analyzed. Compared with the control group, polycystic ovary syndrome group BMI = 25.048 + 3.557 22.660 more than that of control group (3.580), and there was statistical difference (P0.05); the trigger on serum LH in the control group and the polycystic ovary syndrome group comprehensive statistical results were 1.910 (1.140), 1.190 (0.620), and in the control group showed a relatively high level, the difference was statistically significant (P0.05); two the pregnancy rate of group ( The number of cases of pregnancy / the total number of cases) compared to control group 15/25, polycystic ovary syndrome group 4/17 control group, the pregnancy rate was higher in the PCOS group, the difference was statistically significant (P0.05). The trigger on serum E2, P, the number of oocytes, fertilization rate of two groups had no significant difference (P0.05) by Pearson. Expression of Beclin1 m RNA were related with polycystic ovary syndrome group BMI, serum P value, the correlation between the rate of fertilization; using Spearman rank correlation analysis respectively the expression of Beclin1 m RNA and polycystic ovary syndrome group, serum LH level, serum E2 value, a correlation between the number of eggs the study showed that the expression of Beclin1. M RNA and polycystic ovary syndrome in the group of BMI, the correlation coefficient of the number of oocytes were p =0.332, r=0.310 had a significant positive correlation, but had no statistical significance (P0.05); the expression of Beclin1 m RNA in women with polycystic ovary syndrome and other clinical data of syndrome group No correlation. Compare the expression of 19 cases of pregnancy and 23 cases of non pregnancy Beclin1 m RNA and Atg5 m RNA, two gene expression was higher in non pregnant group, and Beclin1 m RNA in the two groups there was significant difference in the expression (P0.05). Conclusion: 1 Beclin1 m RNA and Atg5 m RNA in the two groups were expressed, suggesting that autophagy exists in the Crown Hill of.2 in granulosa cells of Beclin1 m RNA expression had statistical significance between the two groups (P0.05), and the expression of polycystic ovary syndrome group than in the control group, from a hint of polycystic ovary syndrome group of autophagy. Higher than the control group, that of granulosa cells by enhancing autophagy activity against ovarian microenvironment and repair the damage caused by.3 Beclin1 and Atg5 respectively in autophagosome formation started,.Beclin1 plays an important role in the expression of RNA m between the two groups in extension There was statistical significance (P0.05), no significant difference in the expression of Atg5m RNA between the two groups (P0.05), Crown Hill granulosa cells showed that PCOS patients and the change of autophagy process, further support.4 still need large sample of polycystic ovary syndrome group and follow-up study of corona cumulus granulosa cells autophagy activity increased with BMI, on the trigger serum LH, E2, P do not close relationship, namely the clinical data above is not the main factor of change of autophagy particle corona cumulus effect is not affected by the Crown Hill granulosa cell autophagic activity leads to the pregnancy rate of group.5 decreased comparison between pregnancy and non pregnancy, autophagic activity differences, and non pregnancy group of autophagy. High, still need more clinical data analysis, find the reasons for the difference of autophagic activity in patients with PCOS.6 Kaohsiung hormone, blood glucose, blood lipid, fasting insulin, the presence of smoke exposure will affect the Crown Hill etc. Autophagy in granulosa cells process, whether by changing the Crown Hill and the egg quality of granulosa cell autophagy thereby affecting the pregnancy rate still need further discussion and verification of.7 PCOS and PCO in patients with granulosa cell autophagy Crown Hill is whether there are differences, also need to further explore the.8 this paper discusses the relationship between autophagy and PCOS particles on the Crown Hill, PCOS. Provides a new way to study the molecular mechanisms of the development potential, but there are still many problems need to be discussed urgently to explore.

【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R711.75

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 陳子江;林其德;王謝桐;田秦杰;朱依敏;朱桂金;喬杰;喬寵;劉平;劉興會;劉嘉茵;阮祥燕;孫峗;李大金;李天照;張丹;張建平;陳倩;郁琦;羅頌平;金莉萍;趙愛民;段濤;洪燕;姚元慶;黃荷鳳;盛燕;梁曉燕;鮑時華;顏軍昊;;孕激素維持早期妊娠及防治流產(chǎn)的中國專家共識[J];中華婦產(chǎn)科雜志;2016年07期

2 楊曉清;羅麗;高玉華;張偉;孫武;高光玲;牛瓊?cè)A;;廣元地區(qū)妊娠期糖尿病發(fā)病情況及影響因素分析[J];中國計劃生育和婦產(chǎn)科;2016年06期

3 趙晶晶;;地屈孕酮與黃體酮膠丸在先兆流產(chǎn)治療中的應(yīng)用分析[J];中國實用醫(yī)藥;2016年14期

4 ;女性高催乳素血癥診治共識[J];中華婦產(chǎn)科雜志;2016年03期

5 朱曉艷;季蘭萍;劉長躍;;復(fù)方醋酸環(huán)丙孕酮聯(lián)合二甲雙胍對多囊卵巢綜合征患者內(nèi)分泌及代謝影響的Meta分析[J];生殖與避孕;2016年03期

6 王雪;張翠蓮;張少娣;王全麗;羅堂苗;張國玲;夏威;;體質(zhì)量指數(shù)對多囊卵巢綜合征患者移植優(yōu)質(zhì)胚胎后早期妊娠丟失的影響[J];實用婦產(chǎn)科雜志;2016年03期

7 李建薇;張倩瑩;;內(nèi)科內(nèi)分泌疾病與復(fù)發(fā)性流產(chǎn)[J];實用婦產(chǎn)科雜志;2016年02期

8 靳萍萍;;阿司匹林和低分子肝素治療習(xí)慣性流產(chǎn)的臨床效果[J];臨床醫(yī)學(xué);2016年01期

9 林素霞;黃榮富;吳端宗;王育梅;陳小莉;吳培雅;李金姑;姚建鳳;;人卵丘細(xì)胞GREM1基因表達(dá)與卵母細(xì)胞發(fā)育潛能關(guān)系研究[J];中國實用婦科與產(chǎn)科雜志;2015年06期

10 孫峗;劉平;葉虹;伍瓊芳;劉欣燕;楊慧霞;李蓉;喬杰;;黃體支持與孕激素補(bǔ)充共識[J];生殖與避孕;2015年01期

相關(guān)碩士學(xué)位論文 前1條

1 趙葦;HCG注射日E_2水平對多囊卵巢綜合征患者IVF-ET結(jié)局的影響[D];浙江大學(xué);2013年

，

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