多囊卵巢综合征患者高抗苗勒氏管激素水平升高的原因分析  

Cause analysis of high anti-Mullerian hormone level in patients with polycystic ovarian syndrome

作　　者：贺玲[1] 徐杰伟[1] 王婷 黄永汉[1] HE-Ling;XU Jie-wei;WANG Ting;HUANG Yong-han(Department of Reproductive Center,Foshan First People’s Hospital,Foshan 528000,China)

机构地区：[1]佛山市第一人民医院生殖医学中心,528000

出　　处：《妇产与遗传（电子版）》2020年第2期11-15,共5页Obstetrics-Gynecology and Genetics (Electronic Edition)

基　　金：2017年度佛山市卫生和计划生育局医学科研课题立项(20170036)。

摘　　要：目的探讨多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者血清抗苗勒氏管激素(anti-Mulerian hormone,AMH)水平升高的原因。方法选择2017年1月至2018年12月于佛山市第一人民医院首次行IVF/ICSI助孕治疗并采用短效长方案患者(n=466)的临床资料,将患者分为PCOS组(n=101)、卵巢多囊样改变(polycystic ovarian morphology,PCOM)组(n=115)和正常卵巢形态值(对照组)(n=250),比较各组间的年龄、体重指数(BMI)、血清AMH水平、窦卵泡数(antral follicle counting,AFC)、AMH/AFC比值及各项激素参数指标的差异,采用多元线性回归分析可能与AMH水平相关的因素。结果与对照组相比,PCOS组和PCOM组的血清AMH水平和AFC较高,组间差异有统计学意义(P<0.05);PCOS组、PCOM组的AMH/AFC比值与对照组相似(P>0.05)。AMH水平与AFC、基础LH水平呈正相关,与BMI呈负相关(P<0.05)。结论PCOS患者高血清AMH水平是窦卵泡数量增多的累加效应。PCOS患者高AMH水平与单个窦卵泡异常过度分泌的关系,需要控制其他影响因素,更大样本量的研究来证实。Objective To investigate the causes of elevated serum anti-Mullerian hormone(AMH)levels in patients with polycystic ovary syndrome(PCOS).Methods The clinical data of patients(n=466)who underwent the long protocol IVF/ICSI program for the first time in Foshan First People’s Hospital from January 2017 to December 2018 were selected.The patients were divided into polycystic ovary syndrome(PCOS)group(n=101),polycystic ovarian morphology(PCOM)group(n=115)and normal control group(n=250).The age,body mass index(BMI),serum AMH level,antral follicle number(AFC),the ratio of AMH/AFC and various hormone parameters among the groups were compared,and the related factors of serum AMH level were analyzed by multiple linear regression.Results Compared with the control group,the serum AMH level and AFC of the PCOS group and the PCOM group were higher,and there differences between the groups were statistically significant(P<0.05);the AMH/AFC ratio of the PCOS group and PCOM group was similar to the control group(P>0.05).AMH level was positively correlated with AFC and basal LH level,negatively correlated with BMI(P<0.05).Conclusions The high level of serum AMH in PCOS patients is due to the cumulative effect of the increase in the number of antral follicles.The relationship between high AMH level in PCOS patients and excessive secretion of single antral follicle needs to be confirmed by controlling other influencing factors and having a larger sample research.

关 键 词：多囊卵巢综合征 抗苗勒管激素 AMH/AFC比值 

分 类 号：R711[医药卫生—妇产科学]