生殖医学杂志

目的 探讨多囊卵巢综合征(PCOS)不孕症患者子宫内膜组织中微小RNA-21(miR-21)、miR-155的表达及其与内膜容受性的关系。方法 选取2019年5月至2021年8月在本院生殖医学科就诊的148例PCOS不孕症患者为PCOS组，另选取同期在本院体检并明确因男性因素不孕的135例女性为对照组。又根据子宫内膜容受性检测结果将PCOS组分为容受性良好组(46例)和容受性不良组(102例)。进行子宫内膜组织取材，采用实时荧光定量聚合酶链式反应(qRT-PCR)检测子宫内膜组织中miR-21、miR-155的表达水平。比较各组的一般资料及miR-21、miR-155表达水平，采用多因素Logistic回归分析PCOS不孕症患者子宫内膜容受性的影响因素。结果 PCOS组和对照组的一般资料无显著性差异(P>0.05);PCOS组miR-21、miR-155表达水平均显著高于对照组(P均<0.05)。子宫内膜容受性不良组miR-21、miR-155表达水平均显著高于容受性良好组(P均<0.05);容受性不良组的年龄、体质量指数(BMI)、不孕年限、PCOS病程及不孕症类型与容受性良好组比较均无显著性差异(P均>0.05);容受性不良组的搏动指数(PI)、阻力指数(RI)显著高于容受性良好组(P<0.05),子宫内膜厚度(Em)及孕酮(P)、雌二醇(E₂)水平均显著低于容受性良好组(P均<0.05)。多因素Logistic回归分析结果显示，miR-21、miR-155表达水平和PI、RI、Em、P及E₂水平均是PCOS不孕症患者子宫内膜容受性的影响因素(P均<0.05)。结论 PCOS不孕症患者子宫内膜组织miR-21、miR-155表达水平均显著高于对照人群，二者与PI、RI、Em及P、E₂水平均是子宫内膜容受性的显著影响因素。

Objective:To investigate the expressions of microRNA-21(miR-21) and miR-155 in endometrial tissues and the relationship with endometrial receptivity in infertile patients with polycystic ovary syndrome(PCOS).Methods:A total of 148 infertile patients with PCOS treated in the department of reproductive medicine of our hospital from May 2019 to August 2021 were selected as the PCOS group, and 135 women who underwent physical examination in our hospital at the same period and confirmed to be infertile due to male factors were selected as the control group. According to the endometrial receptivity test results, the patients in PCOS group was divided into good endometrial receptivity group(n=46) and poor endometrial receptivity group(n=102). Endometrial tissues of the two groups were collected, and the expression levels of miR-21 and miR-155 in endometrial tissues were detected by real-time fluorescence quantitative polymerase chain reaction(qRT-PCR). The general data, the expression levels of miR-21 and miR-155 in endometrial tissues of patients were compared between the two groups. Multivariate logistic regression was used to analyze the influence factors of endometrial tissues in infertile patients with PCOS.Results:There was no significant difference in general data between PCOS group and control group(P>0.05). The expression levels of miR-21 and miR-155 in the PCOS group were significantly higher than those in the control group(P<0.05). The expression levels of miR-21 and miR-155 in the poor endometrial receptivity group were significantly higher than those in the good endometrial receptivity group(P<0.05). There were no significant differences in age, body mass index(BMI),infertility duration, course of PCOS and type of infertility between the poor endometrial receptivity group and the good endometrial receptivity group(P>0.05). The pulsatility index(PI) and resistance index(RI) in the poor endometrial receptivity group were significantly higher than those in the good endometrial receptivity group(P>0.05). The endometrial thickness(Em),progesterone(P) and estrogen(E₂) in the poor endometrial receptivity group were significantly lower than those in the good endometrial receptivity group(P<0.05). The results of multivariate logistic regression analysis showed that the expression levels of miR-21 and miR-155,PI,RI,Em, P and E₂ were the influencing factors of endometrial receptivity in infertile patients with PCOS(P<0.05).Conclusions:The expression levels of miR-21 and miR-155 in endometrium of infertile patients with PCOS were significantly higher than those of control women. miR-21 & miR-155,PI,PI,EM,P and E₂ were the influence factors affecting endometrial receptivity.