心率变异性中高频功率与IVF/ICSI-ET患者妊娠结局的关系  

Relationship between high-frequency power in heart rate variability and pregnancy outcomes in patients with IVF/ICSI-ET

作　　者：董英辉 李慧 戴芳芳 薄皓月 郝润丰 赵晓丹 王树松 郑波 DONG Ying-hui;LI Hui;DAI Fang-fang;BO Hao-yue;HAO Run-feng;ZHAO Xiao-dan;WANG Shu-song;ZHENG Bo(Xingtai Infertility Specialist Hospital,Xingtai 054001;Hebei Research Institute for Family Planning/Key Laboratory of National Health Commission for Family,Shijiazhuang 050051)

机构地区：[1]邢台不孕不育专科医院,邢台054001 [2]河北省计划生育科学技术研究院/河北省生殖医学重点实验室,石家庄050051

出　　处：《生殖医学杂志》2024年第2期180-186,共7页Journal of Reproductive Medicine

基　　金：河北省医学科学研究课题计划(20221861)。

摘　　要：目的探讨心率变异性(HRV)中高频功率(HF)与接受体外受精/卵胞浆内单精子注射-胚胎移植(IVF/ICSI-ET)治疗的不孕患者妊娠结局的相关性。方法对2022年1—6月于邢台不孕不育专科医院接受IVF/ICSI-ET治疗的329例女性患者的临床资料进行回顾性分析。将研究对象根据HF水平按三分位法分成A组(HF 7.91~197.06,n=110)、B组(HF 198.22~358.03,n=109)和C组(HF 360.03~3121.14,n=110),比较3组患者的心理测评结果[焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分]、子宫内膜情况及妊娠结局。采用Spearman相关分析HF水平与心理状况及结局指标的相关性。结果3组间患者一般资料及基础内分泌水平等比较均无统计学差异(P>0.05)。3组间SAS评分存在显著性差异(P<0.05),其中C组SAS评分显著低于A组(P<0.05);3组间SDS评分比较无统计学差异(P>0.05)。子宫内膜容受性方面,C组内膜血流搏动指数、子宫内膜蠕动波频率均显著低于A、B组[分别为(1.68±0.59)vs.(1.97±0.39)、(1.88±0.39);(1.76±0.93)vs.(2.68±1.58)、(2.30±1.36)](P<0.05)。胚胎结局方面,C组的正常受精率显著高于A、B两组(66.59%vs.60.03%、63.03%,P<0.05),种植率显著高于A组(54.49%vs.40.96%,P<0.05)。相关性分析结果显示,HF水平与SAS评分、蠕动波频率呈负相关(P<0.01),与种植率呈正相关(P<0.05)。结论HRV中的HF可能反映了机体对心理压力的调整能力;较高的HF水平可能预示着较好的子宫内膜容受性及种植率;医务人员应重视HRV的检测,及时进行干预,适当提高其HF水平。Objective:To explore the correlation between high frequency power(HF)in heart rate variability(HRV)and pregnancy outcomes of patients undergoing IVF-ET.Methods:Clinical data of 329 patients received IVF/ICSI-ET in Xingtai Infertility Specialist Hospital from January 2022 to June 2022 were analyzed retrospectively.According to the tertiles of HF levels,the patients were divided into three groups,group A(HF 7.91-197.06,n=110),group B(HF 198.22-358.03,n=109)and group C(HF 360.03-3121.14,n=110).The results of psychological assessment results[self-rating anxiety scale(SAS)score,self-rating depression scale(SDS)score],endometrial condition,and pregnancy outcome were compared among the three groups.Spearman correlation was used to analyze the correlation between HF and SAS,SDS scores and pregnancy outcome indicators.Results:There was no difference in general information and basic endocrinology hormone level among the three groups.There was a significant difference in the SAS score among the three groups(P<0.05).The SAS score of group C was significantly lower than that of group A(P<0.05).There was no significant difference in the SDS score among the three groups(P>0.05).In terms of endometrial receptivity,the pulsatility index(PI)of endometrial blood flow[(1.68±0.59)vs.(1.97±0.39),(1.88±0.39)],the frequency of endometrial peristalsis[(1.76±0.93)vs.(2.68±1.58),(2.30±1.36)]in group C were significantly lower than those in group A and group B(all P<0.05).In terms of embryonic outcomes,the fertilization rate of group C was significantly higher than that of group A and group B(66.59%vs.60.03%,63.03%,P<0.05),and implantation rate(54.49%vs.40.96%)was significantly higher than that of groups A(P<0.05).The correlation analysis results showed that HF was negatively correlated with SAS score and peristaltic wave frequency(P<0.01),and positively correlated with implantation rate(P<0.05).Conclusions:HF in HRV may reflect the body’s good ability to regulate psychological stress.A higher HF may indicate better endometrial rece

关 键 词：自主神经系统 高频功率 子宫内膜容受性 妊娠结局 

分 类 号：R749.2[医药卫生—神经病学与精神病学] R711.6[医药卫生—临床医学]