体外受精与胚胎移植过程中甲襞微循环的变化  

Variation of Nailfold Microcirculation in Patients Undergoing in Vitro Fertilization and Embryo Transfer

作　　者：张昌军[1] 王华[1] 熊静[1] 周艳梅[1] 刘浩[1] 刘海湘[1] 陶连方[1] 罗清炳[1] 郑燕[1] 郑艳[1] 

机构地区：[1]郧阳医学院附属人民医院生殖医学研究中心,湖北十堰442000

出　　处：《中国微循环》2006年第1期54-57,共4页Journal of Chinese Microcirculation

摘　　要：目的了解体外受精-胚胎移植（IVF-ET）周期治疗中患者甲襞微循环的变化及其与获卵数、胚胎质量、IVF结局之间的关系.方法监测103名不孕女性患者总共112个IVF-ET周期治疗中和56例正常健康妇女甲襞微循环积分在月经期、增殖期及分泌期的变化,同时用放射免疫法测定患者各期血清中的雌二醇和孕酮水平.结果（1）促排卵治疗患者和正常健康妇女甲襞微循环状况随着月经期、增殖期及分泌期的演进逐渐好转,但不孕患者甲襞微循环积分较正常对照组积分值明显偏高,差异具有极显著意义.（2）体外受精-胚胎移植人群的甲襞微循环积分与雌二醇、孕酮水平无相关;（3）治疗组中根据获卵数分为高反应组（获卵数〉10个）,中反应组（获卵数6～10个）及低反应组（获卵数〈5个）.在月经期及分泌期,高反应组（获卵数≥10个）的微循环积分较其它两组明显低,分别为2.908±1.471 vs 4.068±1.218,3.319±1.348和1.243±0.522 vs 1.937±0.853,1.892±1.097,差异具有显著意义,而增殖期无差异.（4）在促排卵过程中微循环状况与胚胎质量呈正相关;（5）妊娠组的微循环状况好于未妊娠组;（6）在增殖期及分泌期,年龄≤35岁组的微循环状况好于年龄〉35岁组.结论促排卵周期中微循环状况与月经周期密切相关,微循环状况关系促排卵效果、胚胎质量及着床,进而影响IVF结局.Objective To study the relationship between the number of acquired ooeytes , embryo quality, the outcome of IVF and the variation of nailfold microcirculation. Methods Nailfold microcircutation score of 103 infertile patients（ 112 IVF cycle in all） and 56 normal controls was detected at menstrual stage, proliferative stage and secretive stage. Estrogen and progesterone level was tested at same time by radio-immunoassay. Results （1） Nailfold microcirculation status of patients undergoing controlled-ovarian hyperstimulation and normal control are gradully better from menstrual stage, proliferative stage to secretive stage. In spite of these, nailfold microcireulation scores of infertile patients are significantly higher than those of normal control. （2） No correlation was found between nailfold microcirculation and estrogen, progesterone level in patients undergoing IVF. （3）Therapeutic patients were divided into three groups-high reaction group （the number of acquired oocytes was more than 10）, middle reaction group（ the number of acquired oocytes ranges from 6 to 10） and low reaction group （the number of acquired oocytes was less than 5）. The microcirculation status of high reaction group （the number of acquired oocytes was more than 10） is significantly better than two of the other groups at menstrual stage and secretive stage （2.908 1.471 vs 4.068 1. 218, 3.319 ± 1. 348 and 1. 243 ± 0. 522 vs 1. 937 ± 0. 853, 1. 892 ± 1. 097, respectively）. （4） Microcireulation status is positively correlated with embyo quality through controUed-ovarian hyperstimulation process. （53. 319 ± 1. 348 and 1. 243 ±0.522） Microcirculation status in pregnancy is better when compared with non-pregnancy. （6） Microcirculation status of patients whose age is younger than 35 is better than whose age is over 35 at proliferative stage and secretive stage. Conclusion Microcirculation status is closely correlated with menstrual cycle through controlled-ovarian hyperstimulation process. Microc

关 键 词：甲襞微循环 促排卵 体外受精 胚胎移植 妊娠 

分 类 号：R711[医药卫生—妇产科学] R331.35[医药卫生—临床医学]