多囊性卵巢综合征患者AMH水平与雌激素水平及妊娠结局的关系研究  

Relationship between the level of AMH and estrogen,pregnancy outcomes in patients with polycystic ovary syndrome

作　　者：张平 曹浩哲 曹晶 刘宪 Zhang Ping;Cao Haozhe;Cao Jing;Liu Xian(Department of Reproductive Medicine,First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061,Shanxi,China)

机构地区：[1]西安交大一附院生殖医学科,陕西西安710061

出　　处：《贵州医药》2022年第3期343-345,共3页Guizhou Medical Journal

摘　　要：目的探究多囊性卵巢综合征(PCOS)患者抗缪勒管激素(AMH)水平与雌激素水平及妊娠结局的关系。方法选取因PCOS引起不孕经多囊门诊促排卵指导同房或人工授精治疗后妊娠的患者362例,根据AMH水平分将所有患者分为低水平组(n=121,AMH≤5.25 ng/mL)、中水平组(n=126,5.25 ng/mL<AMH≤10.56 ng/mL)和高水平组(n=115,AMH>10.56 ng/mL)。比较三组一般资料、基础激素水平、子宫内膜及排卵情况、妊娠结局等相关指标,并对影响PCOS患者妊娠结局的相关因素进行Logistic多因素回归分析。结果高水平组血清睾酮(T)、黄体生成素(LH)、卵泡刺激素(FSH)高于低水平组和中水平组(P<0.05);高水平组人绒毛膜促性腺激素(HCG)日雌二醇(E 2)水平高于低水平组和中水平组,窦状卵泡计数(AFC)少于低水平组和中水平组(P<0.05);三组临床妊娠率、多胎妊娠率及多囊促排减胎情况比较差异均无统计学意义(P>0.05)。多因素Logistic回归分析显示,年龄、AFC是影响PCOS患者临床不良妊娠结局的独立危险因素(P<0.05)。结论AMH水平会影响PCOS患者的基础激素水平,但对临床妊娠没有明显影响。Objective To explore relationship between the level of anti-Mullerian hormone(AMH)and estrogen level,and relate the pregnancy outcomes in patients with polycystic ovary syndrome(PCOS).Methods During the period from February 2015 to May 2019,clinical data of PCOS-induced infertility women who were pregnant after treated with ovulation induction intercourse or artificial insemination were enrolled,and they were divided into the low-level group(n=121,AMH≤5.25 ng/mL),the middle-level group(n=126,5.25 ng/mL<AMH≤10.56 ng/mL)and the high-level group(n=115,AMH>10.56 ng/mL)according to different AMH levels.The general data,levels of basic hormones,endometrium,ovulation status and pregnancy outcomes were compared among the three groups.Logistic multivariate regression analysis was performed on related factors which influenced pregnancy outcomes of PCOS patients.Results The serum levels of testosterone(T),luteinizing hormone(LH),and follicle stimulating hormone(FSH)in the high-level group were higher than those in the low-level group and the middle-level group,and there were statistically significant differences(P<0.05).The level of daily human chorionic gonadotropin(HCG)E 2 in the high-level group was higher than that in the low-level group and the middle-level group,while the antral follicular count(AFC)was less than that in the low-level group and the middle-level group(P<0.05).There were no statistically significant differences in the rate of clinical pregnancy,multiple pregnancy and polycystic fetal reduction in the three groups(P>0.05).Multivariate Logistic regression analysis showed that age and AFC were independent risk factors for adverse clinical outcomes in PCOS patients(P<0.05).Conclusion AMH level will influence levels of basal hormonesin PCOS patients,without significant effect on clinical pregnancy.

关 键 词：多囊性卵巢综合征 抗缪勒管激素 雌激素 妊娠结局 

分 类 号：R711.75[医药卫生—妇产科学]