卵泡液BMP-15、TNF-α与不孕患者卵巢反应性的关系及其对妊娠结局的预测价值  

Relationship between follicular fluid BMP-15,TNF-αand ovarian reactivity in infertile patients and its predictive value for pregnancy outcome

作　　者：刘新美 邵娟 王亚茹 LIU Xin-mei;SHAO Juan;WANG Ya-ru(Gynecology and Obstetrics Department,Xi′an Fifth Hospital,Xi′an,Shaanxi 710002;Gynecology and Obstetrics Department,Xi′an Maternal and Child Health Hospital,Xi′an,Shaanxi 710002)

机构地区：[1]西安市第五医院妇产科,西安710002 [2]西安市妇幼保健院妇产科,西安710002

出　　处：《中国优生与遗传杂志》2020年第12期1535-1538,共4页Chinese Journal of Birth Health & Heredity

摘　　要：目的探讨卵泡液中BMP-15和TNF-α与不孕患者卵巢反应性的关系以及其对妊娠结局的预测价值。方法回顾性分析2018年6月-2019年3月期间在我院接受治疗的157例不孕患者的病例资料,根据其卵巢反应性将其分为不良组(n=62)和正常组(n=95),出院后对患者进行为期1年的随访,根据妊娠结局分为妊娠组(n=52)和未妊娠组(n=105);采用单影响分析分析不孕患者的卵巢反应性的影响因素,使用Logistic多因素回归分析以及受试者工作特征曲线(ROC)分析卵泡液BMP-15、TNF-α对不孕患者妊娠结局的预测价值。结果对不同卵巢反应的不孕患者临床指标显示,年龄、基础AFC、基础FSH、GN使用量、卵泡液BMP-15、TNF-α水平和获卵数不同,差异有统计学意义(P<0.05);对不同妊娠结局的不孕患者临床指标显示,患者的年龄、基础FSH、卵泡液BMP-15、TNF-α和获卵数是可以影响患者的妊娠情况结局;对不同妊娠结局患者的进一步Logistic回归分析结果显示,卵泡液中BMP-15、TNF-α指标是影响妊娠结局的独立因素(P<0.05);ROC曲线分析结果显示,BMP-15、TNF-α预测不孕患者妊娠结局预后价值的AUC分别为0.748、0.830,两项联合预测妊娠结局AUC为0.877,联合预测不孕患者妊娠结局预后价值准确性高。结论卵泡液BMP-15、TNF-α是影响不孕患者卵巢反应性和妊娠结局的影响因素,卵泡液BMP-15、TNF-α指标与不孕患者卵巢反应呈现正相关,与患者妊娠结局呈现负相关,且卵泡液BMP-15、TNF-α对不孕患者的妊娠结局有预测价值。Objective:To investigate the relationship between BMP-15 and TNF-αin follicular fluid and ovarian responsiveness in infertile patients and its predictive value for pregnancy outcome.Methods:Retrospective analysis of 157 cases of infertility treated in our hospital from June 2018 to March 2019,They were divided into bad group(n=62)and normal group(n=95),The patients were followed up for one year after discharge,divided into pregnancy group(n=52)and non-pregnant group(n=105);Single effect analysis was used to analyze the influencing factors of ovarian reactivity in infertile patients,Logistic multivariate regression analysis and the working characteristic curve(ROC)were used to analyze the predictive value of follicular fluid BMP-15、TNF-αon pregnancy outcome of infertile patients.Results:Clinical indicators of infertility with different ovarian responses show,The age,base AFC、base FSH、GN usage,level BMP-15、TNF-αfollicular fluid and number of eggs,difference was statistically significant(P<0.05);Clinical indicators for infertile patients with different pregnancy outcomes,The patient’s age,basic FSH、follicle BMP-15、TNF-αand egg number can affect the pregnancy outcome;Further Logistic regression analysis of patients with different pregnancy outcomes,BMP-15、TNF-αindex in follicular fluid is an independent factor affecting pregnancy outcome(P<0.05);ROC curve analysis shows,BMP-15、TNF-αprognostic value of pregnancy outcomes in infertile patients was AUC 0.748,0.830,Both combined predicted pregnancy outcomes AUC 0.877,The prognostic value of predicting pregnancy outcome in infertile patients is high.Conclusion:Follicular fluid BMP-15、TNF-αis the influencing factor of ovarian reactivity and pregnancy outcome in infertile patients.Follicular fluid BMP-15、TNF-αis positively correlated with ovarian response in infertile patients and negatively correlated with pregnancy outcome.And follicular fluid BMP-15、TNF-αhas predictive value for pregnancy outcome of infertile patients.

关 键 词：卵泡液 卵巢反应 妊娠 预测价值 

分 类 号：R711.6[医药卫生—妇产科学]