目的 检测多囊卵巢综合征（PCOS）不孕患者卵泡液（FF）中性激素和胰岛素水平与颗粒细胞中人第10号染色体缺失的磷酸酶和张力蛋白同源物（PTEN）mRNA表达水平，并初步阐释胰岛素水平与PTEN mRNA表达水平的相关性。 方法 选取70例不孕患者作为研究对象，根据不孕因素，分为PCOS组和对照组（输卵管阻塞或男方因素不孕），所有患者均接受体外受精-胚胎移植（IVF-ET）治疗，在取卵当天收集患者FF和卵巢颗粒细胞，采用实时荧光定量PCR（RT-qPCR）法检测2组患者卵巢组织颗粒细胞中PTEN mRNA表达水平；采用电化学发光法检测2组患者FF中性激素和胰岛素水平；采用Spearman相关性分析法分析2组患者卵巢颗粒细胞中PTEN mRNA表达水平和FF中睾酮（T）水平与FF中胰岛素水平的相关性。 结果 2组患者年龄、不孕年限、体质量指数（BMI）、基础性激素、促性腺激素（Gn）总剂量和促排天数比较差异无统计学意义（P>0.05）；与对照组比较，PCOS组患者抗缪勒管激素（AMH）和窦卵泡计数（AFC）均明显升高（P<0.05）。RT-qPCR法，PCOS组患者卵巢颗粒细胞中PTEN mRNA水平高于对照组（P<0.001）。电化学发光法，PCOS组患者FF中T和胰岛素水平高于对照组（P<0.05），雌激素和孕激素水平均低于对照组（P<0.05）。Spearman相关性分析，PCOS组患者FF中T水平和卵巢颗粒细胞中PTEN mRNA表达水平与FF中胰岛素水平均呈正相关关系（r=0.577，P<0.001；r=0.616，P<0.001），而对照组患者FF中T水平和卵巢颗粒细胞中PTEN mRNA表达水平与FF中胰岛素水平无相关性（r=0.266，P=0.123；r=-0.214，P=0.216）。 结论 PCOS不孕患者颗粒细胞中高表达PTEN可能与卵巢内局部高胰岛素水平有关，PTEN参与PCOS的发生发展过程。

Objective To detect the levels of sex hormones and insulin in follicular fluid（FF） and the expression level of phosphatase and tensin homolog deleted on chromosome ten（PTEN） in granulosa cells in the infertile patients with polycystic ovary syndrome（PCOS）， and to preliminarily explain the correlations between the insulin level and the expression level of PTEN mRNA. Methods Seventy infertile patients were selected as the subjects and divided into PCOS group and control group （tubal obstruction or infertility due to male factors） according to infertility factors. All patients received in vitro fertilization-embryo transfer（IVF-ET） treatment. FF and ovarian granulosa cells were collected on the day of ovulation. The expression levels of PTEN mRNA in ovarian granulosa cells of the patients in two groups were detected by real-time fluorescence quantitative PCR（RT-qPCR） method. The levels of sex hormone and insulin in FF were measured by electrochemiluminescence. The correlations of the PTEN mRNA expression level in ovarian granulosa cells and testosterone（T） in FF with the level of insulin in FF were analyzed by Spearman correlation analysis method. Results There were no significant differences in age， infertility years， body mass index （BMI）， basic sex hormone， total dose of gonadotropin（Gn） and days of ovulation induction in two groups（P>0.05）. Compared with control group， the anti-Mullerian hormone（AMH） and antral follicle counting（AFC） of the patients in PCOS group were significantly increased（P<0.05）. The RT-qPCR results showed that the PTEN mRNA expression level in ovarian granulosa cells of the patients in the PCOS group was higher than that in control group（P<0.001）. The electrochemiluminescence results showed that the levels of T and insulin in FF of the patients in PCOS group were higher than those in control group（P<0.05）， whereas the estrogen and progesterone levels were lower than those in control group（P<0.05）. The Spearman correlation analysis showed that that T level in FF was positively correlated with the insulin level of the patients in PCOS group（r=0.577， P<0.001）， and the PTEN mRNA expression level in ovarian granulosa cells was positively correlated with the insulin levels in FF （r=0.616， P<0.001）； in control group， there was no correlation between T level and insulin level in FF（r=0.266， P=0.123）， and there was no correlation between the expression level ofPTEN mRNA in granulosa cells and the insulin level in FF in control group （r=-0.214， P=0.216）. Conclusion The high expression of PTEN in granulosa cells of the infertile patients with PCOS may be related to the local hyperinsulin level in the ovary， and PTEN participates in the occurrence and development of PCOS.