血清抗苗勒管激素水平与正常育龄女性生育力的相关性  

Correlation between serum anti-Müllerian hormone levels and fertility in healthy women of childbearing age

作　　者：郭锐[1] 张亚杰[1] 傅杨 王蕊[1] 李霞[2] GUO Rui;ZHANG Ya-jie;FU Yang;WANG Rui;LI Xia(Department of Reproductive Medicine,Jinan Maternal and Child Health Care Hospital,Jinan 250001;Department of Physical Examination,Jinan Maternal and Child Health Care Hospital,Jinan 250001)

机构地区：[1]济南市妇幼保健院生殖医学科,济南250001 [2]济南市妇幼保健院健康查体科,济南250001

出　　处：《生殖医学杂志》2025年第2期150-156,共7页Journal of Reproductive Medicine

基　　金：济南市卫生健康委员会科技计划项目(2022-2-120)。

摘　　要：目的探讨血清抗苗勒管激素(AMH)水平与正常育龄(25~40岁)女性生育能力的关系。方法选取2022年1—12月于济南市妇幼保健院健康查体科进行免费孕检的25~40岁1200名备孕女性为研究对象。根据年龄不同分为25~34岁组(800例)和35~40岁组(400例),比较两组间的一般资料[包括体质量指数(BMI)、血压、促甲状腺激素(TSH)、基础性激素及AMH水平、窦卵泡计数(AFC)、备孕时间、空腹血糖]及妊娠结局。又根据AMH水平不同将所有入组患者分为低AMH组(<1.1 ng/ml,388例)和正常AMH组(1.1~3.7 ng/ml,812例),采用单因素和多因素分析AMH相关影响因素。同时,为了进一步分析AMH水平和妊娠结局之间的关系,再将适龄女性(25~34岁组)分为低AMH组(101例)和正常AMH组(699例),比较两组的妊娠结局。结果与25~34岁组比较,35~40岁组血清AMH、LH水平、AFC显著降低(P<0.05),血清FSH水平及备孕时间、BMI>24 kg/m^(2)率显著升高(P<0.05)。单因素分析显示,低AMH组患者年龄35~40岁、BMI>24 kg/m^(2)、现在吸烟的比例显著高于正常AMH组(P<0.05)。Logistic分析结果显示,年龄、BMI均为AMH水平的影响因素(P<0.05)。与25~34岁组比较,35~40岁组临床妊娠率显著降低,胚胎停育率、早期流产率、早期妊娠丢失率显著升高(P<0.05)。25~34岁组中,与正常AMH组比较,低AMH组备孕时间、胚胎停育率、早期流产率、早期妊娠丢失率显著升高,临床妊娠率显著降低(P均<0.05)。结论25~34岁女性血清AMH水平高于35~40岁组,且年龄和BMI均是AMH水平的影响因素。血清AMH水平与年轻育龄女性的临床妊娠率成正向关系,AMH水平越低,年轻育龄女性的临床妊娠率越低,妊娠不良结局风险更高。Objective:To investigate the correlation between serum anti-Müllerian hormone(AMH)levels and the reproductive capacity of healthy women aged 25-40 years.Methods:A total of 1200 pregnant women aged 25-40 years who underwent national free pregnancy examination at the Physical Examination Department of Jinan Maternal and Child Health Hospital from January to December 2022 were selected as the study subjects,and were divided into the group of 25-34 years old(800 cases)and the group of 35-40 years old(400 cases)according to their ages.The general characteristics and pregnancy outcome between the two groups were compared,including the body mass index(BMI),blood pressure,thyroid stimulating hormone(TSH)level,basal sex hormone and AMH levels,antral follicle count(AFC),the duration of preparation for pregnancy,fasting blood glucose.According to the different levels of AMH,all enrolled patients were divided into a low AMH group(<1.1 ng/ml,388 cases)and a normal AMH group(1.1-3.7 ng/ml,812 cases).Univariate and multivariate analyses were conducted to identify the influencing factors of AMH.Meanwhile,in order to further analyze the relationship between AMH levels and pregnancy outcomes,eligible women(aged 25-34)were divided into a low AMH group(101 cases)and a normal AMH group(699 cases),and the pregnancy outcomes of the two groups were compared.Results:Compared with the 25-34 year old group,the serum AMH,LH levels,and AFC in the 35-40 year old group were significantly reduced(P<0.05),while the serum FSH levels,gestational preparation time,and BMI>24 kg/m^(2) rate were significantly increased(P<0.05).The univariate analysis results showed that the proportions of women at the age of 35-40 years,BMI>24 kg/m^(2) and current smokers in the low AMH group were significantly higher than those in the normal AMH group(P<0.05).The results of logistic regression analysis showed that the age and BMI were influential factors of AMH level(P<0.05).Compared with the 25-34 years old group,the 35-40 years old group had a significantly lower

关 键 词：育龄女性 生育力 抗苗勒管激素 妊娠结局 

分 类 号：R714.8[医药卫生—妇产科学]