摘要目的 探索体外培养子宫腺肌病(AM)子宫平滑肌细胞钾离子通道的表达情况及雌、孕激素对其的调节作用.方法 选择2009年9月至2010年3月在北京协和医院行手术治疗的AM患者22例(AM组),以同期宫颈上皮内瘤变Ⅲ级切除子宫者12例作为对照组,应用逆转录PCR技术检测体外培养的子宫平滑肌细胞大电导钙激活钾离子通道α亚基(BKCaα)、电压依赖性钾离子通道4.3(Kv4.3)mRNA的表达及对不同浓度雌、孕激素作用的反应性.结果 AM组子宫平滑肌细胞BKCa α和Kv4.3 mRNA的表达量(分别为4.43±2.05、4.52± 1.97)显著高于对照组(分别为0.83±0.25、0.86±0.19),分别比较,差异均有统计学意义(P＜0.05).10.0 nmol/L 17β-雌二醇使AM组子宫平滑肌细胞BKCaαmRNA表达量(0.56±0.27)显著下降,与未用药(1.01±0.35)比较,差异有统计学意义(P＜0.05);0.1、1.0 nmol/L浓度的17β-雌二醇使对照组子宫平滑肌细胞Kv4.3 mRNA表达量明显下降(分别为0.17±0.10、0.13±0.08),与未用药(0.55±0.29)比较,差异均有统计学意义(P＜0.05).0.1μmol/L孕酮使对照组子宫平滑肌细胞BKCaαmRNA表达量(0.44±0.24)和Kv4.3 mRNA表达量(1.29±0.51)明显升高(P＜0.05);而AM组使用不同浓度孕酮后BKCaα和Kv4.3 mRNA的表达量均无变化(P＞0.05).结论 AM子宫平滑肌细胞存在钾离子通道的异常表达,其受高浓度雌激素的调节并可能存在孕激素抵抗.

abstractsObjective To investigate the expression of potassium channels and the influence of estrogen and progesterone on the cultured uterine smooth muscle cells (USMC) of adenomyosis in vitro.Methods There were 22 cases of adenomyosis hysterectomy in the adenomyosis group and 12 patients with cervical intraepithelial neoplasia Ⅲ removal of the uterus in the control group.USMC were separated and cultured in vitro, incubated with different concentrations of estrogen and progesterone.We used reverse transcription-PCR to dectect the expression of large-conductance calcium-and voltage-sensitive potassium channel α subunit (BKCa α) and voltage-gated potassium channel 4.3 (Kv4.3).Results The mRNA expression of BKCa α and Kv4.3 in the adenomyosis group (4.43 ±2.05 and 4.52± 1.97) were significantly higher than those in the control group (0.83±0.25 and 0.86±0.19, P＜0.05).In the control group, Kv4.3 mRNA decreased after treated with 0.1 nmol/L (0.17±0.10) and 1.0 nmol/L (0.13±0.08) estrogen than before (0.55±0.29, P＜0.05).In the adenomyosis group, BKCa α mRNA decreased significantly after treated with 10.0 nmol/L estrogen (0.56±0.27 versus 1.01±0.35, P＜0.05).0.1 μmol/L progesterone elevated both BKCa α mRNA (0.44±0.24 versus 0.16±0.09) and Kv4.3 mRNA (1.29±0.51 versus 0.55±0.29) in the control group (all P＜0.05);however, there were no significant difference in adenomyosis group of different concentration of progestrone (P＞0.05).Conelusuion There is an abnormal expression of potassium channels in the adenomyosis USMC, which is regulated by high concentration of estrogen and might be resistant to progesterone.