不同输卵管系膜状态子宫内膜异位囊肿患者术后血清抗苗勒管激素水平差异分析  

Analysis of the difference of serum anti-mullerian hormone levels in patients with endometriotic cysts with different mesosalpinal status after ovarian cystectomy

作　　者：魏佳 卢春梅 邵勇[4] 胡琢瑛[5] 喻杨[6] WEI Jia;LU Chun-mei;SHAO Yong;HU Zhuo-ying;YU Yang(Department of Obstetrics and Gynecology,Longquanyi District of Chendu Maternity and Child Health Care Hospital,Chengdu 610000,Sichuan Province,China;Department of Obstetrics and Gynecology,the People′s Hospital of Longchang City,Longchang 642150,Sichuan Province,China;Pidu Maternity and Child Health Care Hospital of Chengdu,Chengdu 610000,Sichuan Province,China;Department of Obstetrics,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400000,China;Department of Gynecology,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400000,China;Department of Cardiology,Xinqiao Hospital Affiliated to the Army Medical University,Chongqing 400000,China)

机构地区：[1]成都市龙泉驿区妇幼保健院妇产科,四川成都610000 [2]隆昌市人民医院妇产科,四川隆昌642150 [3]成都市郫都区妇幼保健院,四川成都610000 [4]重庆医科大学附属第一医院产科,重庆400000 [5]重庆医科大学附属第一医院妇科,重庆400000 [6]第三军医大学附属新桥医院心内科,重庆400000

出　　处：《新乡医学院学报》2019年第6期566-570,共5页Journal of Xinxiang Medical University

摘　　要：目的分析子宫内膜异位囊肿患者输卵管系膜状态与卵巢囊肿剥除术后血清抗苗勒管激素(AMH)水平的关系。方法选择2014年2月至2017年2月隆昌市人民医院收治的74例子宫内膜异位囊肿患者为研究对象,根据输卵管系膜是否粘连分为2组,系膜与囊肿或附件发生粘连者作为观察组(n=31),无粘连者作为对照组(n=43)。2组患者均给予卵巢囊肿剥除术,比较2组患者手术相关指标及剥除囊肿的组织学形态;分别于手术前后检测2组患者血清抗苗勒管激素(AMH)水平,观察2组患者术后卵巢储备功能恢复的差异。结果2组患者手术时间、术中出血量和术后拔管时间比较差异均无统计学意义(P>0.05)。2组患者剥除囊肿直径和囊肿壁厚度比较差异均无统计学意义(P>0.05)。2组患者构成囊肿壁的主要细胞是卵巢间质细胞,囊壁上有明显的纤维化,且有大量的巨噬细胞存在。观察组和对照组患者卵泡存在率分别为41.94%(13/31)、48.84%(21/43),2组患者卵泡存在率比较差异无统计学意义(P>0.05)。术前2周,2组患者血清AMH水平比较差异无统计学意义(P>0.05)。2组患者术后3、12个月血清AMH水平均显著低于术前2周(P<0.05),2组患者术后3、12个月血清AMH水平比较差异无统计学意义(P>0.05)。观察组患者术后3、12个月血清AMH水平均低于对照组(P<0.05)。术前2周,2组患者窦卵泡计数(AFC)比较差异无统计学意义(P>0.05)。2组患者术后3个月AFC显著低于术前2周(P<0.05);术后12个月,观察组患者AFC低于术前2周,对照组患者AFC显著高于术前2周(P<0.05);2组患者术后12个月AFC显著高于术后3个月(P<0.05)。观察组患者术后3、12个月AFC显著低于对照组(P<0.05)。结论卵巢子宫内膜异位囊肿合并输卵管系膜粘连患者行囊肿剥除术后血清AMH水平大幅下降,临床应实时监测AMH水平并加强干预。Objective To analyze the difference of serum anti-mullerian hormone (AMH) levels in patients with endometriotic cysts with different mesosalpinal status after ovarian cystectomy. Methods A total of 74 patients with endometriosis cysts in the Longchang People′s Hospital from February 2014 to February 2017 were selected as the study subjects.The patients were divided into two groups according to whether or not the mesosalpinx was adhesive.Thirty-one patients with adhesion of mesosalpinx and cysts or adnexa uteri were selected as observation group,and 43 patients without adhesion were selected as control group.All patients were given ovarian cystectomy.The operation related indexes and the histological morphology of cysts was compared between the two groups.Serum levels of AMH were measured before and after operation,and the difference in the recovery of ovarian reserve function was observed between the two groups. Results There was no significant difference in the operation time,intraoperative blood loss and postoperative extubation time between the two groups ( P >0.05).There was no significant difference in the cyst diameter and cyst wall thickness between the two groups ( P > 0.05).Pathological results showed that the main cells of the cyst wall in the two groups were ovarian stromal cells,with obvious fibrosis in the cyst wall and a large number of macrophages.The follicular existence rates of patients in the observation group and the control group were 41.94%(13/31) and 48.84%(21/43),respectively;there was no significant difference in the follicular existence rates between the two groups ( P >0.05).There was no significant difference in the serum levels of AMH of patients between the two groups at 2 weeks before operation ( P >0.05).The serum levels of AMH at 3,12 months after operation were significantly lower than those at two weeks before operation ( P <0.05);there was no significant difference in the serum levels of AMH of patients between 3 months and 12 months after operation in the two groups ( P >0.0

关 键 词：子宫内膜异位囊肿 输卵管系膜 粘连 卵巢囊肿剥除术 血清抗苗勒管激素 

分 类 号：R711.71[医药卫生—妇产科学]