抗核抗体与体外受精-胚胎移植临床结局的相关性分析  

Correlation analysis of antinuclear antibody and clinical outcome of in vitro fertilization and embryo transfer

作　　者：蒋元华[1] 毛文琪 曾梅芳[1] 苏素勤 莫柠毓 段金良[1] JIANG Yuanhua;MAO Wenqi;ZENG Meifang;SU Suqin;MO Ningyu;DUAN Jinliang(Reproductive Center,924 Hospital of Chinese People's Liberation Army Joint Logistic Support Force,Guilin Guangxi 541001,P.R.China)

机构地区：[1]中国人民解放军联勤保障部队第924医院生殖中心,广西桂林541001

出　　处：《中国计划生育和妇产科》2021年第4期33-36,41,共5页Chinese Journal of Family Planning & Gynecotokology

基　　金：2020年度广西医药卫生科研课题(项目编号:20200972)。

摘　　要：目的探讨抗核抗体(antinuclear antibody,ANA)与体外受精-胚胎移植(in vitro fertilization-embryo transfer,IVF-ET)临床结局的相关性。方法回顾性分析2019年1月至12月中国人民解放军联勤保障部队第924医院1123例IVF-ET不孕患者的临床资料,均检测ANA,根据检测结果分为A组(阳性,467例)、B组(阴性,656例)。A组根据有无临床干预,分为A1组(阿司匹林、糖皮质激素临床干预,230例)、A2组(未干预,237例)。比较各组一般资料、助孕情况及临床结局。结果A1组、A2组、B组平均年龄、基础促卵泡生成素、体质量指数、不孕年限、平均促性腺激素(mean gonadotropin,Gn)用量、平均使用Gn天数、窦卵泡计数、人绒毛膜促性腺激素(human chorionic gonadotropin,hCG)日内膜厚度、hCG日雌二醇水平、不孕原因、平均获卵数、MII卵率、正常受精率、优质胚胎数、可利用胚胎数、平均移植胚胎数比较,差异均无统计学意义(P>0.05);A1组、B组胚胎种植率、临床妊娠率高于A2组,异位妊娠率、早期流产率低于A2组,差异均有统计学意义(P<0.05)。结论ANA阳性可能影响IVF-ET胚胎着床或胚胎发育,而经积极治疗有可能改善临床结局。Objective To investigate the relevance of antinuclear antibodies with clinical outcome of in vitro fertilization and embryo transfer(IVF-ET).Methods A retrospective analysis of the clinical data of 1123 infertility patients undergoing IVF-ET in 924 Hospital of Chinese People’s Liberation Army Joint Logistic Support Force from January 2019 to December 2019.All were tested for antinuclear antibodies,and were divided into group A(positive,n=467)and group B(negative,n=656)according to the test results.Group A was divided into group A1(aspirin,glucocorticoid clinical intervention group,n=230)and group A2(non-intervention group,n=237)according to whether there was clinical intervention.The general information,assisted pregnancy status and clinical outcome of these groups were compared.Results The average age,follicle stimulating hormone(FSH),body mass index,years of infertility,average gonadotropin(Gn)dosage,average Gn days,antral follicles count(AFC),human chorionic gonadotropin(hCG)day endometrial thickness,hCG day estradiol(E2)levels,and causes of infertility,the average number of eggs obtained,the rate of MII eggs,the rate of normal fertilization(2 PN),the number of high-quality embryos,the number of usable embryos,and the average number of embryos transferred in Group A1,Group A2,Group B were not statistically significant(P>0.05);the embryo implantation rate and clinical pregnancy rate of group A1 and group B were higher than group A2,and the rate of ectopic pregnancy and early abortion were lower than group A2,the differences were statistically significant(P<0.05).Conclusion Positive ANA may affect IVF-ET embryo implantation or embryo development,and active treatment may improve the clinical outcome.

关 键 词：抗核抗体 体外受精-胚胎移植 不孕症 相关性 

分 类 号：R711.6[医药卫生—妇产科学]