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[细胞间黏附分子-1和E-选择素在卵巢过度刺激综合征发病机制中的作用]

[Role of intercellular adhesion molecule-1 and E-selectin in the pathogenesis of ovarian hyperstimulation syndrome].

作者信息

Kovachev E, Kozovski I, Markova V, Gemer O, Cherneva S

出版信息

Akush Ginekol (Sofiia). 2005;44(4):26-31.

Abstract

OBJECTIVE

To explore the ICAM-1 and E-selectin in patients with OHSS and clarifying its role in pathogenesis of the syndrome.

MATERIALS AND METHODS

20 patients were included in the research and 20 control patients with stimulating ovarian cycle for the purposes of ART, during the period from 01.01.2004 till 01.01.2005 years in the center of ART-MU-Varna and Department of Obstetrics and Gynecology-IVF-ward-MU-Ben-Gurion, Israel. The patients were divided into 3 subgroups according to the degree of OHSS by the classification of Golan- mild, moderate, severe. The method of ELISA was used to record the values of the factors under research.

RESULTS

Six patients with severe OHSS, showed increase in the value of the ICAM-1 and somebody of them, showed low level of E-selectin testing in serum and ascitic fluid in comparison with the control group and the rest of the patient with OHSS.

CONCLUSION

OHSS is a life-threatening complication in which the main pathophysiology factor is the increased of capillary permeability. ICAM-1 are expressed on human granulosa cells and by the vascular endothelium after the stimulation by inflammatory cytokines and acts as a mediator of the cohesion with the lymphoid cells. E-selectin is produced by the endothelium after cytokine activation. The soluble forms of these molecules are found in serum, follicular fluid during the COH, as well as in ascitic fluid in severe OHSS. In our research adhesion molecules- ICAM-1 are correlated to the OHSS, especially in the severe forms of the syndrome.

摘要

目的

探讨卵巢过度刺激综合征(OHSS)患者体内的细胞间黏附分子-1(ICAM-1)和E-选择素,并阐明其在该综合征发病机制中的作用。

材料与方法

选取2004年1月1日至2005年1月1日期间在保加利亚瓦尔纳市辅助生殖医学中心以及以色列本-古里安大学医学院妇产科IVF病房接受辅助生殖技术(ART)促排卵周期治疗的20例患者作为研究对象,另选20例对照患者。根据戈兰分类法将患者按OHSS程度分为3个亚组:轻度、中度、重度。采用酶联免疫吸附测定(ELISA)法记录研究因素的值。

结果

6例重度OHSS患者的ICAM-1值升高,其中部分患者血清和腹水中的E-选择素检测水平低于对照组及其他OHSS患者。

结论

OHSS是一种危及生命的并发症,其主要病理生理因素是毛细血管通透性增加。ICAM-1在人颗粒细胞上表达,并在炎性细胞因子刺激后由血管内皮细胞表达,作为与淋巴细胞黏附的介质。E-选择素在细胞因子激活后由内皮细胞产生。这些分子的可溶性形式存在于促排卵周期中的血清、卵泡液以及重度OHSS患者的腹水中。在我们的研究中,黏附分子ICAM-1与OHSS相关,尤其是在该综合征的重度形式中。

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