【摘要】 目的:探讨体外受精-胚胎移植患者种植窗期子宫内膜自然杀伤细胞(u NK)对子宫内膜微血管的影响及子宫动脉搏动指数与胚胎种植的关系。方法:回顾性分析本院2009年1月至2013年7月实施体外受精-胚胎移植(IVF-ET)的37例患者的临床资料,根据是否妊娠成功及至少2次行IVF-ET失败分为成功组(26例)和失败组(11例),比较两组研究对象种植窗期的子宫内膜u NK细胞标记物CD56+、子宫动脉搏动指数、血管内皮标记物F8因子、ɑ平滑肌肌动蛋白(ɑSMA)及重链肌球蛋白(SMM)的表达差异及其相互关系。结果:成功组的基础FSH 3.52±0.68(m U/ml)、基础窦卵泡9.44±2.53(个)与失败组比较差异均不具有统计学意义(P>0.05)。成功组的u NK细胞27.18±5.94(%)、MVD 6.79±1.74(%)、ɑSMA 33.72±4.19(%)、SMM 25.19±5.83(%)表达率均显著高于IVF-ET助孕失败组(P<0.05)。种植窗期37例患者的子宫内膜u NK细胞比例与MVD数目、ɑSMA及SMM着色细胞数比例均呈显著的正相关性[(r=0.472,P=0.000<0.005)、(r=0.426,P=0.000<0.005)、(r=0.512,P=0.000<0.05)]。成功组种植窗期的子宫动脉PI=0.94±0.28,失败组的PI=0.87±0.29,两组比较差异不具有统计学意义(t=0.688,P=0.493>0.05)。结论:种植窗期的子宫内膜组织中自然杀伤细胞与子宫内膜血管生成具有显著的相关性,可能与成功妊娠具有一定的关系;子宫动脉PI与妊娠结局是否成功关系不明显。更多还原

【Abstract】 Objective: In vitro fertilization and embryo transplantation in patients with endometrial implantation window phase of natural killer cell( u NK) influence on the endometrial microvascular and uterine artery pulsatility index and embryo implantation. Methods: A retrospective analysis of our hospital from January 2009 to July 2013 the implementation of in vitro fertilization and embryo transfer( IVF-ET) clinical data of 37 patients,according to whether the success of pregnancy and at least 2 times for IVF-ET failure into success group( 26 cases) and the failure group( 11 cases),compared two groups of research object during the window of implantation in the uterus endometrial u NK cell marker CD56+,uterine artery pulsatility index,vascular endothelial marker F8 factor,alpha smooth muscle actin( alpha SMA) and myosin heavy chain( SMM) and the relationship between the expression of difference. Results: Success group based FSH 3. 52 ± 0. 68( m U / ml),basal antral follicles of 9. 44 ± 2. 53 compared with the failure group differences were not statistically significant( P>0. 05). The successful group of u NK cells of 27. 18±5. 94( %),MVD 6. 79±1. 74( %),αSMA 33. 72±4. 19( %),SMM 25. 19±5. 83( %) were significantly higher than the expression rate of IVF-ET assisted reproductive failure group( P<0. 05). The number of u NK cells,the proportion of endometrium during the window of implantation and MVD of 37 patients with αSMA and SMM coloring cell number proportion were positive correlation significantly( r = 0. 472,P = 0. 000 <0. 005),( r = 0. 426,P = 0. 000<0. 005),( r = 0. 512,P = 0. 000<0. 05). Success group during the window of implantation in the uterine artery PI = 0. 94±0. 28,PI = 0. 87±0. 29 failure group,differences between the two groups was not statistically significant( t = 0. 688,P =0. 493>0. 05). Conclusion: During the window of implantation in the endometrium of natural killer cells and endometrial angiogenesis was significantly associated with successful pregnancy,may have a certain relationship; uterine artery PI and pregnancy outcome successful has no obviously relationshhip.更多还原