2018 年第 6 期 第 13 卷

卵巢子宫内膜异位症患者卵泡液炎症因子水平和卵丘颗粒细胞的变化及其与体外受精-胚胎移植结局的关系

Relation among inflammatory factors in follicular fluid, cumulus granular cells and vitro fertilization-embryo transfer outcome in patients with ovarian endometriosis

作者：宁艳春王婧瑶赵铭佳耿女刘海静李宜学罗萌萌苏兴崔静韩宝生

英文作者：

单位：063000河北省唐山市妇幼保健院生殖遗传科（宁艳春、赵铭佳、耿女、刘海静、李宜学、罗萌萌、苏兴、崔静、韩宝生）；063000河北省唐山市，华北理工大学临床医学院（王婧瑶)

英文单位：

关键词：卵巢子宫内膜异位症；炎症因子；卵丘颗粒细胞；体外受精-胚胎移植

英文关键词：

• 摘要：

• 【摘要】目的    探讨卵巢子宫内膜异位症（OEM）患者卵泡液中炎症因子水平和卵丘颗粒细胞的变化及其与体外受精-胚胎移植（IVF-ET）结局的关系。方法    选取2013年6月至2015年1月在河北省唐山市妇幼保健院进行IVF-ET助孕的OEM患者152例（OEM组），选择同期因男性因素不孕行IVF-ET助孕的168例为男性因素组，比较2组患者单个卵泡雌激素水平、MⅡ卵率、临床妊娠率。收集取卵当日卵泡液检测IL-6、TNF-α的表达,收集新鲜的卵丘颗粒细胞进行体外培养,观察卵丘颗粒细胞的生长情况和凋亡情况。结果    OEM组卵泡液IL-6、TNF-α水平高于男性因素组［(368±90)ng/L比(46±38)ng/L，(434±153)ng/L比(56±38)ng/L］,单个卵泡雌二醇水平、MⅡ卵率、临床妊娠率低于男性因素组［(163±35)pmol/L比(268±46)pmol/L，（69±8）%比（88±5）%，（33±5）%比（55±4）%］，差异均有统计学意义（均P＜0.05）。经体外培养，OEM组卵丘颗粒细胞凋亡率高于男性因素组［(34.4±4.7)%比（10.7±2.9）%］，差异有统计学意义（P＜0.01）。结论    OEM患者卵泡液中炎症因子可能通过影响卵丘颗粒细胞的生长及凋亡从而影响卵母细胞的成熟,这可能是OEM患者IVF-ET临床结局较差的原因之一。

• 【Abstract】Objective    To analyze the relation among inflammatory factors in follicular fluid, cumulus granular cells and vitro fertilization-embryo transfer（IVF-ET） outcome in patients with ovarian endometriosis（OEM）. Methods    One hundred and fifty-two OEM patients having IVF-ET from June 2013 to January 2015 in Maternal and Child Health Hospital of Tangshan were enrolled as OEM group; 168 healthy women having IVF-ET were enrolled as control group. Estrogen level in single follicle was detected. MⅡ oocyte rate and pregnancy rate were recorded. Levels of interleukin-6（IL-6） and tumor necrosis factor-α（TNF-α） in follicular fluid were tested. Growth and apoptosis of cumulus granular cells were observed in vitro. Results    Levels of IL-6 and TNF-α in follicular fluid in OEM group were significantly higher than those in control group［(368±90)ng/L vs (46±38)ng/L, (434±153)ng/L vs (56±38)ng/L］; estrogen level in single follicle, MⅡ oocyte rate and pregnancy rate in OEM group were significantly lower than those in control group［(163±35)pmol/L vs (268±46)pmol/L， （69±8）% vs （88±5）%， （33±5）% vs （55±4）%］（all P＜0.05）. Apoptosis rate of cumulus granular cells in vitro culture in OEM group was significantly higher than that in control group［(34.4±4.7)% vs （10.7±2.9）%］（P＜0.01）. Conclusion    Inflammatory factors in follicular fluid of OEM patients can affect growth and apoptosis of cumulus granular cells and suppress maturation of oocytes, which is associated with the poor outcome of IVF-ET.