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目的:探讨环氧合酶-2(COX-2)在多囊卵巢综合征(PCOS)患者子宫内膜的表达及治疗后的变化。方法:选择PCOS患者(PCOS组)16例,另选择卵巢功能正常的不孕患者20例为对照组,PCOS组应用二甲双胍/达英-35治疗。所有病例均测体重指数(BMI),抽血测定女性激素六项并行75 g葡萄糖耐量试验(OGTT)和胰岛素释放试验(1RT)。于月经干净3～5天(闭经患者确认为卵泡期)刮取子宫内膜组织,采用免疫组织化学技术检测PCOS组治疗前后及对照组子宫内膜COX-2的表达。结果:PCOS组患者BMIHOMA-IR、空腹胰岛素(I0)、75 g葡萄糖负荷后2 h胰岛素(I120)及T均明显高于家族史阴性患者(P均<0.01);PCOS组治疗前COX-2在子宫内膜的表达显著高于对照组(P<0.01),治疗后其表达明显下降(P<0.05)。结论:PCOS患者子宫内膜可能处于一种慢性炎症状态,子宫内膜COX-2过度表达可能是导致患者子宫内膜异常增生和不孕的原因之一,二甲双胍/达英-35可逆转此变化。
Objective: To investigate the expression of cyclooxygenase-2 (COX-2) in the endometrium of women with polycystic ovary syndrome (PCOS) and its changes after treatment. Methods: Sixteen PCOS patients (PCOS group) were selected. Another 20 normal ovariectomized infertile women were selected as the control group. The PCOS group was treated with metformin / up to -35. All cases were measured body mass index (BMI), blood test six female hormone parallel 75 g glucose tolerance test (OGTT) and insulin release test (1RT). The menstrual clean 3 to 5 days (amenorrhea patients identified as follicular phase) scraping endometrial tissue, using immunohistochemistry to detect PCOS group before and after treatment and control group, endometrial COX-2 expression. Results: The BMI HOMA-IR, fasting insulin (I0), insulin I120 and T at 2 h after glucose loading in PCOS group were significantly higher than those with negative family history (P <0.01) The expression of COX-2 in the endometrium was significantly higher than that in the control group (P <0.01), and the expression of COX-2 was significantly decreased after treatment (P <0.05). CONCLUSION: The endometrium of PCOS patients may be in a chronic inflammatory state. Overexpression of COX-2 in the endometrium may be one of the causes of abnormal endometrial hyperplasia and infertility in patients with PCOS. Metformin / up -35 can reverse this change .