多囊卵巢综合征不孕患者血清miR-363-3p表达与促排卵治疗后临床妊娠的关系  

Correlation between serum miR-363-3p expression and clinical pregnancy after ovulation induction therapy in infertile patients with polycystic ovary syndrome

作　　者：董蕾 史天云[1] 余进松 王志刚 DONG Lei;SHI Tianyun;YU Jinsong;WANG Zhigang(Department of Gynecology,the First People's Hospital of Nanyang,Nanyang,Henan 473200,China)

机构地区：[1]南阳市第一人民医院妇科,河南南阳473200

出　　处：《中华实用诊断与治疗杂志》2024年第7期716-720,共5页Journal of Chinese Practical Diagnosis and Therapy

基　　金：河南省医学科技攻关计划项目(LHGJ20200902)。

摘　　要：目的 观察多囊卵巢综合征(PCOS)不孕患者血清miR-363-3p表达变化,探讨其与促排卵治疗后临床妊娠的关系。方法 2019年1月—2021年12月南阳市第一人民医院诊治PCOS不孕患者115例为PCOS组,同期无PCOS男方因素不孕患者60例为对照组。采用实时荧光定量PCR法检测2组入院次日血清miR-363-3p相对表达量;比较2组年龄、体质量指数、血压、空腹血糖、空腹胰岛素、胰岛素抵抗指数、性激素、抗米勒管激素、血脂等临床资料;采用Pearson相关法分析PCOS患者miR-363-3p相对表达量与空腹胰岛素、胰岛素抵抗指数、性激素、抗米勒管激素、血脂等的相关性。115例PCOS患者均给予规范化促排卵治疗3个周期,67例临床妊娠者为妊娠组,48例受孕失败者为未妊娠组,比较妊娠组与未妊娠组年龄、体质量指数、血压、空腹血糖、空腹胰岛素、胰岛素抵抗指数、性激素、抗米勒管激素、血脂、miR-363-3p相对表达量等临床资料;多因素logistic回归分析PCOS不孕患者促排卵治疗后临床妊娠失败的影响因素。结果 (1)PCOS组胰岛素抵抗指数(2.86±0.58)、空腹胰岛素[(25.63±2.51)mu/L]、促黄体生成素[(14.20±3.49)u/L]、卵泡刺激素[(8.32±1.47)u/L]、睾酮[(0.75±0.21)μg/L]、催乳素[(14.85±2.69)μg/L]、孕酮[(1.21±0.41)nmol/L]和抗米勒管激素[(9.54±2.46)μg/L]水平均高于对照组[1.92±0.41、(12.40±1.24)mu/L、(5.63±0.74)u/L、(5.74±1.05)u/L、(0.42±0.14)μg/L、(10.32±3.51)μg/L、(0.75±0.36)nmol/L、(3.68±1.58)μg/L](P<0.05),雌二醇[(106.41±26.47)pmol/L]水平和miR-363-3p相对表达量(0.46±0.09)均低于对照组[(163.58±32.51)pmol/L、1.00±0.18](P<0.05),年龄、体质量指数、血压、空腹血糖、总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇水平与对照组比较差异均无统计学意义(P>0.05)。PCOS不孕患者miR-363-3p相对表达量与空腹胰岛素(r=-0.753,P<0.001)、胰岛素抵抗指数(Objective To observe the changes of serum miR-363-3p expression in infertile patients with polycystic ovary syndrome(PCOS), and to explore its relationship with clinical pregnancy after ovulation induction therapy. Methods Totally 115 infertile PCOS patients(PCOS group) were diagnosed and treated in the First People's Hospital of Nanyang from January, 2019 to December, 2021, and another 60 patients without PCOS were diagnosed male infertile(control group). Real-time fluorescence quantitative PCR was used to detect the relative expression of serum miR-363-3p on the next day after admission.The age, body mass index, blood pressure, fasting plasma glucose, fasting insulin, insulin resistance index, sex hormone, anti-Müller's hormone, and blood lipid were compared between two groups. Pearson correlation method was used to analyze the correlations of the relative expression of miR-363-3p with fasting insulin, insulin resistance index, sex hormone, anti-Müller's hormone and blood lipid in PCOS patients. All patients in PCOS group were given standardized ovulation induction therapy for 3 courses, and were divided into clinical pregnancy group(n=67) and non-pregnancy group(n=48). The age, body mass index, blood pressure, fasting plasma glucose, fasting insulin, insulin resistance index, sex hormone, anti-Müller's hormone, blood lipid and relative expression of serum miR-363-3p were compared between clinical pregnancy group and non-pregnancy group. Multivariate logistic regression analysis was done to evaluate the influencing factors of clinical pregnancy failure in PCOS patients after ovulation induction therapy. Results(1) The insulin resistance index, fasting insulin, luteinizing hormone, follicle stimulating hormone, testosterone, prolactin, progesterone and anti-Müller's hormone were higher in PCOS group [2.86±0.58,(25.63±2.51) mu/L,(14.20±3.49) u/L,(8.32±1.47) u/L,(0.75±0.21) μg/L,(14.85±2.69) μg/L,(1.21±0.41) nmol/L,(9.54±2.46) μg/L] than those in control group [1.92±0.41,(12.40±1.24) mu/L,(5.63±0

关 键 词：多囊卵巢综合征 不孕 miR-363-3p 代谢紊乱 促排卵治疗 临床妊娠 

分 类 号：R711.6[医药卫生—妇产科学]