多囊卵巢综合征不孕女性血清胰岛素样生长因子结合蛋白-3、游离睾酮指数水平及与卵巢储备功能的关系  

Relationship between serum insulin-like growth factor binding protein-3 and free testosterone index and ovarian reserve function in infertile women with polycystic ovary syndrome

作　　者：韩晓 邢琳琳 蔡广彦[1] 原双 HAN Xiao;XING Linlin;CAI Guangyan;YUAN Shuang(Gynecology Department,Qingdao Eighth People's Hospital,Shandong Qingdao 266100,China;Endocrinology Department,Qingdao Eighth People's Hospital,Shandong Qingdao 266100,China)

机构地区：[1]青岛市第八人民医院妇科,山东青岛266100 [2]青岛市第八人民医院内分泌科,山东青岛266100

出　　处：《中国实验诊断学》2024年第7期799-803,共5页Chinese Journal of Laboratory Diagnosis

摘　　要：目的 分析多囊卵巢综合征(PCOS)不孕女性血清胰岛素样生长因子结合蛋白-3(IGFBP-3)、游离睾酮指数(FAI)水平及其与卵巢储备功能的关系。方法 回顾性分析青岛市第八人民医院收治的120例PCOS不孕女性(观察组)和42名健康体检女性(对照组)的临床资料。比较观察组和对照组研究对象血清IGFBP-3及FAI水平,并统计观察组患者卵巢储备功能情况,比较卵巢储备功能正常、卵巢储备功能低下患者的基线资料,分析PCOS不孕女性卵巢储备功能低下的影响因素,血清IGFBP-3、FAI水平与PCOS不孕女性卵巢储备功能的关系及其对PCOS不孕女性卵巢储备功能低下的预测效能。结果 与对照组比较,观察组患者血清IGFBP-3水平更低,FAI水平更高(P<0.05)。120例PCOS不孕女性中,38例存在卵巢储备功能低下。与卵巢储备功能正常患者比较,卵巢储备功能低下患者的盆腔炎发生率、婚姻不满意占比及FAI水平更高(P<0.05),血清IGFBP-3水平更低(P<0.05);多因素Logistic回归分析显示盆腔炎(95%CI:1.151~6.290)、婚姻满意程度(95%CI:1.033~4.952)、血清IGFBP-3水平(95%CI:0.040~0.286)及FAI水平(95%CI:10.024~185.807)是PCOS不孕女性的卵巢储备功能低下的影响因素(P<0.05)。Pearson分析显示血清IGFBP-3水平与卵巢储备功能呈正相关关系(r=0.513,P<0.05),FAI水平与卵巢储备功能呈负相关关系(r=-0.495,P<0.05)。ROC曲线分析血清IGFBP-3、FAI水平及两者联合预测PCOS不孕女性卵巢储备功能低下的AUC分别为0.786、0.845、0.912,且联合预测的AUC值更高(P<0.05)。结论 与正常人群比较,PCOS不孕女性血清IGFBP-3水平更低,与卵巢储备功能呈正相关关系;FAI水平更高,与卵巢储备功能呈负相关关系,即血清IGFBP-3水平越低,FAI水平越高,卵巢储备功能越低下,血清IGFBP-3联合FAI水平对卵巢储备功能低下具有较好的预测效能。Objective To analyze the levels of serum insulin-like growth factor binding protein-3(IGFBP-3),free testosterone index(FAI)and their relationship with ovarian reserve in infertile women with polycystic ovary syndrome(PCOS).Methods The data of 120 PCOS infertile women and 42 healthy women admitted to our hospital were analyzed retrospectively.Serum IGFBP-3 and FAI levels were compared between the observation group and the control group, and the ovarian reserve function of the observation group was statistically analyzed.Baseline data of patients with normal ovarian reserve function and low ovarian reserve function were compared, and the influencing factors of low ovarian reserve function in infertile women with PCOS were analyzed.Relationship between serum IGFBP-3 and FAI levels and ovarian reserve function in infertile women with PCOS and their predictive efficacy for low ovarian reserve function in infertile women with PCOS.Results Compared with the control group, the serum IGFBP-3 level in the observation group was lower and the FAI level was higher(P<0.05).Of 120 infertile women with PCOS,38 had low ovarian reserve.Compared with patients with normal ovarian reserve function, patients with low ovarian reserve function had higher levels of pelvic inflammatory disease, marital dissatisfaction and FAI,and lower levels of serum IGFBP-3(P<0.05).Multivariate Logistic regression analysis showed that pelvic inflammatory disease(95%CI:1.151~6.290),marital satisfaction(95%CI:1.033~4.952),serum IGFBP-3 level(95%CI:0.040~0.286)and FAI level(95%CI:0.040~0.286)(10.024~185.807)was the influential factor of low ovarian reserve function in infertile women with PCOS(P<0.05).Pearson analysis showed that serum IGFBP-3 level was positively correlated with ovarian reserve function(r=0.513,P<0.05),and FAI level was negatively correlated with ovarian reserve function(r=-0.495,P<0.05).ROC curve showed that the AUC of serum IGFBP-3 and FAI levels and their combined prediction of low ovarian reserve function in infertile women with PCOS

关 键 词：多囊卵巢综合征 不孕 女性 血清胰岛素样生长因子结合蛋白-3 游离睾酮指数 卵巢储备功能 

分 类 号：R711.75[医药卫生—妇产科学]