不孕妇女乙肝病毒感染者的卵巢储备功能研究  

Ovarian reserve function in infertile women with HBV infection

作　　者：柳榴 刘倩[1] 文妍琪[1] 杨菁[1] 

机构地区：[1]武汉大学人民医院生殖医学中心,武汉430060

出　　处：《生殖医学杂志》2016年第1期27-31,共5页Journal of Reproductive Medicine

基　　金：国家自然科学基金面上项目(No.81370767)

摘　　要：目的评价乙型肝炎病毒（HBV）感染及HBV-DNA高拷贝数的不孕妇女的卵巢储备功能。方法回顾性分析来院进行体外受精/卵胞浆内单精子注射-胚胎移植（IVF/ICSI-ET）治疗的505例不孕患者,根据血清HBsAg是否阳性及HBV-DNA滴度将实验对象分为3组：血清HBsAg（-）为A组;血清HBsAg（＋）,HBV-DNA〈500IU/ml为B组;HBsAg（＋）,HBV-DNA≥500IU/ml为C组。评估3组患者的基本情况,并以血清基础FSH、LH、E2水平和AFC等为指标,分析比较HBV感染状态与卵巢储备功能的关系。结果（1）HBV-DNA阳性率（滴度≥500IU/ml）在HBV感染的不孕妇女中为48.60%,平均HBV-DNA拷贝数为5.86×104 IU/ml（5×102~1.28×109 IU/ml）;（2）与A组相比,C组患者中AFC〈6的发生率更高（9.62%vs.2.06%）,差异有统计学意义（P〈0.05）;且C组患者在卵巢储备功能低下（AFC〈6）的不孕妇女群体中所占的比例显著高于在卵巢储备功能正常（AFC≥6）的不孕妇女群体中所占的比例（45.4%vs.19.5%,P〈0.05）,而A组患者在卵巢储备功能低下的不孕妇女群体中所占的比例明显低于在卵巢储备功能正常的不孕妇女群体中所占的比例（27.3%vs.59.0%,P〈0.05）,B组则在两个群体所占的比例无显著差异（27.3%vs.21.5%,P〉0.05）;（3）多元逻辑回归分析显示,与A组相比,C组卵巢储备功能低下的风险更高[OR3.689,95%CI（1.043,13.048）]（P〈0.05）。结论在HBV感染的妇女中,HBV-DNA高拷贝数可能是卵巢储备功能低下的高危因素,其可能会影响不孕女性的卵巢储备功能。Objectives： To evaluate the ovarian reserve function in the infertile women with HBV infection HBV-DNA high copy number. Methods： A retrospective analysis based on the medical records of 505 patients undergone IVF/ICSI- ET treatment in the hospital was performed. The patients were divided into three groups according to whetheR HBsAg existed and the serum titer of HBV-DNA： group A with HBsAg （ - ） ; group B with serum HBsAg （＋） ＆ HBV-DNA〈500 IU/ml;group C with HBsAg （＋） ＆ HBV-DNA≥500 IU/ml. The basic condition and ovarian reserve indicators such as serum FSH, LH, E2 levels, and antral follicle count （AFC） in the three groups were analyzed and compared. Results： The positive rate of HBV-DNA （≥500 IU/ml） was 48. 60% in the infertile women with HBV （q-）. The titer of HBV-DNA varied from 5× 102IU/ml to 1.28×109 IU/ml with an average of 5.86 × 104 IU/ml. There was a significant higher percentage of AFC〈6 in group C compared with group A （9.62G vs. 2.06% ,P〈0. 05）. The proportion of patients with DOR （diminished ovarian reserve,AFC〈6） was significantly higher than that with normal ovarian reserve （AFC≥6） in group C （45.4% vs.19. 53% ,P〈0.05）. Conversely, the proportion of patients with DOR was significantly lower than that with normal ovarian reserve in group A （27.3% vs. 59.0%,P〈0.05）. The two proportions were not significantly different in Group B （27.3% vs. 21.5% ,P）0. 05）. Multivariate logistic regression analysis showed that the risk of DOR was significantly higher in group C Eodds ratios （OR）： 3.689, 95% confidence interval （CI） ： 1. 043-13. 0481 compared with group A （P〈0.05）. Conclusions： HBV-DNA high copy number may be a high risk factor for diminished ovarian reserve in HBV-infected women. It may affect the ovarian reserve function of infertile women.

关 键 词：HBV HBV-DNA 不孕 卵巢储备功能 

分 类 号：R[医药卫生]