生长激素释放肽、褪黑素在年轻宫颈癌患者化疗后血清中的水平变化及其与卵巢储备功能相关性研究  

Changes in serum levels of Ghrelin and melatonin in young patients with cervical cancerafter chemotherapy and their correlation with ovarian reserve function

作　　者：孙长青 李敏[1] 孟令军 刘翠 张娜[1] SUN Changqing;LI Min;MENG Lingjun;LIU Cui;ZHANG Na(Qilu Hospital of Shandong University Dezhou Hospital,Dezhou 253000,China)

机构地区：[1]山东大学齐鲁医院德州医院,山东德州253000

出　　处：《陕西医学杂志》2025年第2期205-208,213,共5页Shaanxi Medical Journal

基　　金：山东省医药卫生科技发展计划项目(2018WS522)。

摘　　要：目的:探讨生长激素释放肽(Ghrelin)、褪黑素(MT)在年轻宫颈癌患者化疗后血清中的水平变化及其与卵巢储备功能的相关性。方法:选取接受化疗的年龄在18~35岁的宫颈癌患者156例为研究对象,根据化疗3个月后卵巢储备功能是否下降将患者分为功能减退组(95例)和功能正常组(61例)。比较两组临床资料及血清Ghrelin、MT水平。采用Logistic回归分析宫颈癌患者化疗后卵巢储备功能减退的影响因素。采用Pearson法分析患者血清Ghrelin、MT与卵泡刺激素(FSH)、FSH/黄体生成素(LH)、雌二醇(E2)、抗米勒管激素(AMH)水平的相关性。绘制受试者工作特征(ROC)曲线分析血清Ghrelin、MT对宫颈癌患者化疗后卵巢储备功能减退的预测价值。结果:与功能正常组比较,功能减退组患者血清FSH、E2水平、FSH/LH比值升高,AMH水平降低(均P<0.05)。功能减退组患者血清Ghrelin和MT水平低于功能正常组(均P<0.05)。血清Ghrelin、MT、FSH、FSH/LH、E2和AMH是宫颈癌患者化疗后卵巢储备功能减退的影响因素(均P<0.05)。血清Ghrelin、MT与FSH、FSH/LH、E2水平呈负相关,与AMH水平呈正相关(均P<0.05)。血清Ghrelin、MT联合预测宫颈癌患者化疗后卵巢储备功能减退的曲线下面积(AUC)大于两者单独预测的AUC(均P<0.05)。结论:年轻宫颈癌患者化疗后血清Ghrelin、MT水平降低,是患者化疗后卵巢储备功能减退的影响因素,且两者联合对化疗后卵巢储备功能减退的预测价值较高。Objective:To explore the changes in serum levels of Ghrelin and melatonin(MT)in young patients with cervical cancer after chemotherapy and their correlation with ovarian reserve function.Methods:A total of 156 cervical cancer patients aged 18 to 35 who underwent chemotherapy were selected as the study subjects.According to whether the ovarian reserve function decreased after 3 months of chemotherapy,the patients were divided into the function decline group(95 cases)and the function normal group(61 cases).Clinical data and serum levels of Ghrelin and MT were compared between the two groups.Logistic regression analysis was used to identify factors affecting the decline in ovarian reserve function after chemotherapy in cervical cancer patients.Pearson’s correlation analysis was used to assess the correlation between serum Ghrelin and MT levels and follicle-stimulating hormone(FSH),FSH/luteinizing hormone(LH),estradiol(E2),and anti-Müllerian hormone(AMH)levels.The receiver operating characteristic(ROC)curve was plotted to analyze the predictive value of serum Ghrelin and MT for the decline in ovarian reserve function after chemotherapy in cervical cancer patients.Results:Compared with the function normal group,the function decline group had increased serum levels of FSH and E2,an increased FSH/LH ratio,and decreased AMH levels(all P<0.05).Patients in the function decline group had lower serum levels of Ghrelin and MT than those in the function normal group(all P<0.05).Serum Ghrelin,MT,FSH,FSH/LH,E2 and AMH were factors affecting the decline in ovarian reserve function after chemotherapy in cervical cancer patients(all P<0.05).Serum Ghrelin and MT were negatively correlated with FSH,FSH/LH and E2 levels,and positively correlated with AMH levels(all P<0.05).The combined predictive AUC for serum Ghrelin and MT for the decline in ovarian reserve function after chemotherapy in cervical cancer patients was greater than that of individual predictions(all P<0.05).Conclusion:Decreased serum levels of Ghrelin and MT in youn

关 键 词：宫颈癌 生长激素释放肽 褪黑素 卵巢储备功能 影响因素 预测价值 

分 类 号：R737.33[医药卫生—肿瘤]