血清VEGF、ES水平與多囊卵巢綜合征患者卵巢間質血流的關系

蔣雪霞　尹道英　李曉玲　楊艷　王博偉

[摘要] 目的 探討血清血管內皮生長因子（VEGF）、內皮抑素（ES）與多囊卵巢綜合征患者（PCOS）卵巢間質血流的關系。 方法 選取重慶市永川區中醫院（以下簡稱“我院”）2016年1月～2017年12月收治的PCOS患者89例為PCOS組，并根據胰島素抵抗指數將PCOS組分為胰島素抵抗組（n = 47）和非胰島素抵抗組（n = 42），另選同期健康體檢女性50名為對照組，采用酶聯免疫吸附法（ELISA）檢測VEGF、ES水平，采用彩色多普勒超聲監測搏動指數（PI）、阻力指數（RI）、峰值血流速度（PSV），采用Pearson檢驗分析VEGF、ES與卵巢間質血流指標的相關性。結果 PCOS組VEGF、ES、PSV水平高于對照組，PI、RI低于對照組，差異有統計學意義（P < 0.05）。胰島素抵抗組VEGF、ES、PSV水平高于非胰島素抵抗組，PI、RI低于非胰島素抵抗組，差異有統計學意義（P < 0.05）。PCOS患者的VEGF、ES與PI、RI呈負相關（rVEGF = -0.476、-0.491;rES = -0.423、-0.365，P < 0.05），與PSV呈正相關（rVEGF = 0.504、rES = 0.463，P < 0.05）。 結論 PCOS患者的VEGF、ES水平呈高表達，并且隨著患者胰島素抵抗增加而升高，抗血管生成治療有望成為新的治療靶點。

[關鍵詞] 多囊卵巢綜合征;血管內皮生長因子;內皮抑素;卵巢間質血流

[中圖分類號] R711.75 ? ? ? ? ?[文獻標識碼] A ? ? ? ? ?[文章編號] 1673-7210（2019）05（c）-0085-04

[Abstract] Objective To investigate the relationship between serum vascular endothelial growth factor （VEGF）， endostatin （ES） and ovarian stromal blood flow in patients with polycystic ovary syndrome （PCOS）. Methods A total of 89 patients with PCOS admitted to Yongchuan District Traditional Chinese Medical Hospital of Chongqing City （"our hospital" for short） from January 2016 to December 2017 was recorded as PCOS group. According to insulin resistance index， PCOS group was divided into insulin resistance group （n = 47） and non-insulin resistance group （n = 42）. Another 50 healthy women in the same period were selected as control group. Enzyme-linked immunosorbent assay （ELISA） was used to detect the level of VEGF and ES. The pulsatility index （PI）， resistance index （RI） and peak velocity （PSV） was monitored by color Doppler ultrasound. Pearson test was used to analyze the correlation between VEGF， ES and ovarian stromal blood flow. Results The levels of VEGF， ES and PSV in PCOS group were higher than that control group， and PI and RI in PCOS group were lower than that in control group （P < 0.05）. The levels of VEGF， ES and PSV in insulin resistance group were higher than that in non-insulin resistance group， and PI and RI in insulin resistance group were lower than that in non-insulin resistance group （P < 0.05）. In PCOS patients， the levels of VEGF and ES were negatively correlated with PI and RI （rVEGF = -0.476， -0.491， rES = -0.423， -0.365， P < 0.05）， and positively correlated with PSV （rVEGF = 0.504， rES = 0.463，P < 0.05）. Conclusion The levels of VEGF and ES in PCOS patients are highly expressed， and increase with the increase of insulin resistance. Antiangiogenesis therapy is expected to become a new therapeutic target.