【摘要】：目的觀察吡格列酮對(duì)多囊卵巢綜合征(PCOS)患者卵巢顆粒細(xì)胞雌激素分泌功能和其上P450芳香化酶(P450arom)、胰島素受體底物-1(IRS-1)和胰島素受體底物-2(IRS-2)表達(dá)的影響。方法對(duì)27例行體外受精-胚胎移植PCOS患者的顆粒細(xì)胞進(jìn)行體外原代培養(yǎng)并分組,A組分別加入不同濃度(0、10、102、103、104nmol/L)吡格列酮、B組為不同濃度吡格列酮與卵泡刺激素(FSH,50ng/L)及C組為不同濃度吡格列酮與胰島素樣生長因子-Ⅰ(IGF-Ⅰ,50ng/L)。用放射免疫法檢測(cè)培養(yǎng)上清液中雌二醇(E2)濃度,Real-time PCR法檢測(cè)顆粒細(xì)胞上P450arom、IRS-1、IRS-2mRNA的表達(dá)變化。結(jié)果在A、B、C組中,人PCOS卵巢顆粒細(xì)胞培養(yǎng)48h的E2產(chǎn)生量差異有統(tǒng)計(jì)學(xué)意義(P0.05),吡格列酮各濃度組間P450arom mRNA表達(dá)量差異有統(tǒng)計(jì)學(xué)意義(P0.05),隨著吡格列酮濃度的增加,E2水平和P450arom mRNA表達(dá)也隨之下降;人PCOS卵巢顆粒細(xì)胞在相同濃度吡格列酮時(shí),C組E2水平和P450arom mRNA表達(dá)明顯高于B組(P0.01)及A組(P0.01),B組E2產(chǎn)生量和P450arom mRNA表達(dá)高于A組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);人PCOS卵巢顆粒細(xì)胞經(jīng)不同濃度吡格列酮刺激48h,各濃度組間IRS-1、IRS-2mRNA表達(dá)差異有統(tǒng)計(jì)學(xué)意義(P0.05),隨著吡格列酮濃度的增加,IRS-1mRNA表達(dá)隨之下降,IRS-2mRNA表達(dá)隨之上升。結(jié)論吡格列酮可能直接或間接通過對(duì)P450arom的抑制,減少E2的生成,改善顆粒細(xì)胞上IRS-1和IRS-2表達(dá)的失衡,抑制PCOS卵巢的局部胰島素抵抗?fàn)顟B(tài);吡格列酮可抑制FSH和IGF-Ⅰ刺激卵巢顆粒細(xì)胞分泌雌激素的功能。
[Abstract]:Objective to observe the effects of pioglitazone on estrogen secretion and P450 aromatase (P450arom) in granulosa cells of patients with polycystic ovary syndrome (PCOS). Effects of insulin receptor substrate-1 (IRS-1) and insulin receptor substrate-2 (IRS-2) expression. Methods the granulosa cells of 27 PCOS patients undergoing in vitro fertilization and embryo transfer were cultured in vitro and divided into two groups. Group A was treated with different concentrations of pioglitazone (0102103104nmol / L), group B was treated with different concentrations of pioglitazone and follicle stimulating hormone (FSH,). 50ng/L and group C were treated with different concentrations of pioglitazone and IGF- 鈪，

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