FSH基值、垂体兴奋试验及克罗米芬刺激试验在预测卵巢功能衰竭中的价值  

The Values of Basal FSH and Its Responsive Value to GnRH or Clomiphene Citrate for Predicting Ovarian Failure

作　　者：徐肖文[1] 吕杰强[1] 林金芳[2] 王乐丹[1] 林明[1] 涂权梅[1] 

机构地区：[1]温州医学院附属第二医院妇产科,325027 [2]复旦大学附属妇产科医院

出　　处：《医学研究杂志》2011年第5期130-134,共5页Journal of Medical Research

摘　　要：目的通过对卵巢功能衰退患者相关生殖激素指标的跟踪观察,探讨其在预测3年内卵巢功能衰竭中的价值。方法测定卵巢功能衰退患者FSH基值及对促性腺激素释放激素(GnRH)和克罗米酚(CC)的反应峰值,跟踪观察直至卵巢功能衰竭(观察终点)。分析上述各项指标与卵巢储备功能变化的相关关系。通过受试者操作特征曲线(ROC曲线)寻找预测3年内卵巢功能衰竭的bFSH、FSH峰值和FSHD10值的最佳临界点及其灵敏度和特异度。结果研究组妇女FSH基值、GnRH和CC药物峰值均明显高于对照组,差异有显著性(P<0.05)。通过ROC曲线发现,预测3年内卵巢功能衰竭的最佳临界点bFSH为12.95IU/L,FSH峰值为18.60IU/L,FSHD10值为20.33IU/L。结论 FSH基值或药物峰值≥10IU/L提示卵巢储备功能下降并为卵巢功能进入衰退阶段的指标。bFSH、FSH峰值及FSHD10值用于预测3年内卵巢功能衰竭的最佳临界点bFSH为12.95IU/L,FSH峰值为18.60IU/L,FSHD10值为20.33IU/L。To explore the relationship between the ovarian reserve function changes and relative endocrine indicators, then to screen the predictive hormones and to determine predictive values for ovarian function failure within three years. Methods 120 cases of menstrual disorder with basal FSH ≥ 10IU/L or its responsive value to GnRH or clomiphene citrates≥ 10IU/L were selected as our study group. And 40 infertility cases with normal menstrual cycle, hiphasic BBT, serum basal FSH and the same responsive values 〈 1OIU/L were as control group. The study group was designed to follow up to the stage of ovarian function failure （ study end point）. The differences between the two groups in these above indicators correlated with ovarian reserve function were compared by using One - way ANOVA. Receiver operator characteristic curve （ ROC curve） was used to find the critical values of bFSH, peak FSH value and FSHD10 that might best predict ovarian function failure within three years. Results All the markers had significant difference between the two groups except bE2. It showed that the values of bFSH, peak FSH and FSHD10 in the women assigned to the research groups were signifi- cant higher than those in the control groups（ P 〈 0.05）. Using ROC curve, we found the critical values of various indicators for predicting ovarian failure within three years： bFSH 12.95IU/L, pFSH 18.6OIL/L, FSHD10 20.33IU/L. Conclusion Basal FSH and its responsive value to GnRH or clomiphene citrate ≥ 10IU/L indicated the beginning of ovarian function decline. The critical values for predicting ovarian failure within three years in women with declining ovarian function were： bFSH 12.95 IU/L, pFSH 18.60 IU/L and FSHD10 20.33 IU/L.

关 键 词：卵巢功能 基础促性腺激素 垂体兴奋试验 克罗米芬刺激试验 预测 

分 类 号：R713.420.6[医药卫生—妇产科学]