血清E2/P、AMH及25(OH)D3水平在冻融胚胎移植妊娠中的临床意义  

Clinical significance of serum E2/P,AMH,and 25(OH)D3 levels in frozen thawed embryo transfer pregnancy

作　　者：张皙卉 卢静[1] 刘宁[1] 张一娇 常文亮[1] 王玉红[1] 赵海君[1] 贺玲 张云静 ZHANG Xihui;LU Jing;LIU Ning;ZHANG Yijiao;CHANG Weniang;WANG Yuhong;ZHAO Haijun;HE Ling;ZHANG Yunjing(Department of Reproductive Medicine,Handan Central Hospital,Handan,Hebei,China,056000;Department of Medical Insurance,Handan Central Hospital,Handan,Hebei,China,056000;Department of Obstetrics,Handan Central Hospital,Handan,Hebei,China,056000)

机构地区：[1]邯郸市中心医院生殖医学科,河北邯郸056000 [2]邯郸市中心医院医保科,河北邯郸056000 [3]邯郸市中心医院产科,河北邯郸056000

出　　处：《分子诊断与治疗杂志》2024年第9期1806-1809,1814,共5页Journal of Molecular Diagnostics and Therapy

基　　金：河北省自然科学基金(H2023206230);邯郸市科学技术研究与发展计划项目(19422083015ZC)。

摘　　要：目的分析血清雌二醇(E2)/孕酮(P)值、抗苗勒管激素(AMH)、血清25羟维生素D3[25(OH)D3]水平在冻融胚胎移植技术(FET)妊娠中的临床意义。方法选取2020年1月至2023年6月邯郸市中心医院收治的214例不孕患者作为研究对象,根据妊娠结局分为妊娠组和未妊娠组。比较两组相关资料;采用多因素Logistic回归分析影响FET妊娠结局的危险因素;采用ROC曲线评估E2/P、AMH及25(OH)D3对FET妊娠结局的预测价值。结果214例接受FET的患者中,共确诊临床妊娠104例(妊娠组),未妊娠者110例(未妊娠组),临床妊娠率为48.59%,两组年龄、移植胚胎数、子宫内膜厚度、E2/P、AMH、25(OH)D3水平比较,差异有统计学意义(P<0.05);经多元Logistic回归分析可知,E2/P、AMH、25(OH)D3值偏低、子宫内膜厚度小、高龄均是影响FET妊娠结局的危险因素(P<0.05);ROC曲线显示,E2/P、AMH与25(OH)D3三者联合预测的AUC值高于各指标单独检测者(P<0.05)。结论血清E2/P、AMH及25(OH)D3水平与不孕患者FET妊娠结局有一定关系,三者联合检测能够更全面地评估患者的妊娠潜力和风险,为临床制定个性化的治疗方案提供参考依据。Objective To analyze clinical significance of serum estradiol(E2)/progesterone(P)values,anti-Mullerian hormone(AMH),and serum 25 hydroxyvitamin D3[25(OH)D3]levels in frozen thawed embryo transfer(FET)pregnancy.Methods A total of 214 infertility patients admitted to Handan Central Hospital from January 2020 to June 2023 were selected as the study subjects.Based on the pregnancy outcome,they were divided into the pregnant group and the non-pregnant group.General data between the two groups were compared.Multivariate logistic regression was used to analyze the risk factors affecting the preg-nancy outcome of FET.The predictive value of E2/P,AMH and 25(OH)D3 for pregnancy outcome of FET was evaluated by ROC curve.Results Of the 214 patients who underwent FET,104 clinical pregnancies were diagnosed(pregnancy group)and 110 were non-pregnant(non-pregnant group),with a clinical preg-nancy rate of 48.59%,Acomparison of age,number of embryos transferred,endometrial thickness,E2/P,AMH,and 25(OH)D3 levels between the two groups showed statistically significant differences(P<0.05).Multivariate logistic regression analyses showed that low values of E2/P,AMH,and 25(OH)D3,low endo-metrial thickness,and advanced age were all risk factors affecting pregnancy outcome in FET(P<0.05).The ROC curves showed that the AUC values predicted by the combination of E2/P,AMH,and 25(OH)D3 were higher than those detected separately for each indicator(P<0.05).Conclusion Serum E2/P,AMH,and 25(OH)D3 levels are associated with FET pregnancy outcomes in infertile patients.The combination of the three tests can more comprehensively assess the pregnancy potential and risk of the patients.This information can provide a reference basis for the clinical development of individualized treatment plans.

关 键 词：血清雌二醇 孕酮 抗苗勒管激素 血清25羟维生素D3 冻融胚胎移植技术 妊娠结局 

分 类 号：R714.8[医药卫生—妇产科学] R446.11[医药卫生—临床医学]