养精种玉汤对原因不明不孕患者子宫内膜基质金属蛋白酶-9表达及性激素调节的影响

Effect of Yangjing Zhongyu Decoction on Matrix Metalloproteinase-9 Expression in Endometrium and Sex Hormone Regulation in Women with Cryptogenic Infertility

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DOI：

中文关键词: 养精种玉汤子宫内膜基质金属蛋白酶-9 金属蛋白酶抑制物-1 性激素

英文关键词:Yangjin Zhongyu decoction endometrium matrix metalloproteinase-9 metalloproteinase inhibitor-1 sex hormone

基金项目:浙江省中医药科研基金项目 (No .2 0 0 0C44)

作者	单位
吴瑞瑾	浙江大学医学院附属妇产科医院杭州310006
周馥贞	浙江大学医学院附属妇产科医院杭州310006

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中文摘要:

目的　探讨养精种玉汤对原因不明不孕患者黄体中期子宫内膜基质金属蛋白酶 9(MMP 9)及其抑制物 1(TIMP 1)表达及性激素调节的影响。方法　采用原位杂交、逆转录聚合酶链反应 (RT PCR)技术 ,对 2 2例原因不明不孕患者服用养精种玉汤前后黄体中期子宫内膜行MMP 9及TIMP 1mRNA检测 ,放射免疫法测定同期血清雌二醇 (E2 )、孕酮 (P)水平。结果　治疗后黄体中期血清E2 水平为 (45 1 5 0 1±2 2 6 342 ) pmol/L ,显著高于治疗前水平 (30 4 6 5 6± 135 85 3)pmol/L ,治疗前后比较 ,差异有显著性 (P <0 0 5 ) ;治疗后血清P水平为 (46 5 0 2± 19 94 8)nmol/L ,显著高于治疗前水平 (33 782± 15 4 5 9)nmol/L ,治疗前后比较 ,差异亦有显著性 (P <0 0 1)。治疗后黄体中期子宫内膜腺上皮细胞胞浆、胞核MMP 9mRNA阳性颗粒较治疗前加深 ,间质变化不显著 ,MMP 9mRNA表达水平 (灰度比值 )为 0 6 17± 0 186 ,显著高于治疗前水平 0 4 90± 0 370 ,治疗前后比较 ,差异有显著性 (P <0 0 5 ) ;治疗前后TIMP 1mRNA在腺上皮、间质表达变化不显著 ,灰度比值分别为 0 5 88± 0 191和 0 6 2 1± 0 14 6 ,差异无显著性 (P >0 0 5 )。相关分析提示 ,治疗前、后P的差值与MMP 9mRNA差值呈正相关 (r =0 6 82 ,P <0

英文摘要:

Objective To investigate the effect of Yangjing Zhongyu decoction （YZD） on metalloproteinase-9 （MMP-9） and its inhibitor-1 （TIMP-1） expression and sex hormone regulation in mid-luteal phase endometrium of women with cryptogenic infertility. Methods In situ hybridization and reverse transcription-polymerase chain reaction method was used to detect MMP-9 and TIMP-1 mRNA,and radioimmunoassay was used to determine levels of serum estradiol （E₂） and progesterone （P） synchronously, of 22 infertile women during mid-luteal phase. Results After treatment, the mid-luteal serum E₂ and P level was 451.501±226.342 pmol/L and 46.502±19.948 nmol/L respectively, significantly higher than that before treatment （304.656±135.853 pmol/L and 33.782±15.459 nmol/L respectively）,the difference was significant （P<0.01）. Staining of MMP-9 mRNA positive granules in cytoplasm and nuclei of adeno-epithelial cell mid-luteal phase endometrium deepened significantly,but the change in mesenchym was insignificant. The MMP-9 mRNA expression after treatment was 0.617±0.186 （grey level）, significantly higher than the level before treatment （0.490±0.370）,comparison between them showed significant difference （P<0.05）. Change of TIMP-1 mRNA expression in adeno-epithelial and mesenchym before and after treatment was insignificant （0.588±0.191 vs 0.621±0.146,P<0.05）. Correlation analysis showed that the quantitative difference of P value before and after treatment was positively correlated with the difference of MMP-9 mRNA before and after treatment （r=0.682,P<0.01）. Conclusion YZD could soothen Gan and nourish Shen,raise the level of mid-luteal phase serum P, and further promote MMP-9 gene expression in endometrium to benefit the degradation of extracellular matrix of endometrium, and facilitate for blastocyst implantation.

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