炔雌醇环丙孕酮对不同抗苗勒管激素表达水平多囊卵巢综合征合并不孕患者治疗效果的影响  

Ethinestradiol cyproterone on polycystic ovaries with different anti-mullerian hormone expression levels

作　　者：王初容[1] 兰苏平[1] 叶咏菊[1] WANG Chu-rong;LAN Su-ping;YE Yong-ju(Department of Obstetrics and Gynecology,Lishui Hospital of Traditional Chinese Medicine,Lishui,Zhejiang 323000,China)

机构地区：[1]丽水市中医院妇产科,浙江丽水323000

出　　处：《中国妇幼保健》2025年第5期866-870,共5页Maternal and Child Health Care of China

基　　金：浙江省中医药科技计划项目(2020ZB297)。

摘　　要：目的 分析炔雌醇环丙孕酮对不同抗苗勒管激素(AMH)表达水平多囊卵巢综合征(PCOS)合并不孕患者治疗效果的影响。方法 选取2021年5月—2023年10月丽水市中医院收治的80例PCOS合并不孕患者为研究对象,按照不同AMH表达水平分组,分为AMH表达浓度较低的患者35例(B组)和AMH表达浓度较高的患者45例(C组),另外选取同期在该院体检的未孕健康女性40例为A组。B组和C组均给予炔雌醇环丙孕酮治疗,A组不进行任何处理。比较3组性激素[睾酮(T)、黄体成生素(LH)及卵泡刺激素(FSH)]、脂代谢[三酰甘油(TG)、胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)及高密度脂蛋白胆固醇(HDL-C)]、糖代谢[空腹胰岛素(FINS)、空腹血糖(FPG)及胰岛素抵抗指数(HOMA-IR)]、肿瘤坏死因子-α(TNF-α)、AMH水平、妊娠率及排卵率。结果 治疗前,A组性激素、脂代谢、糖代谢、TNF-α及AMH水平均低于B组和C组,差异均有统计学意义(均P<0.05)。治疗后,与A组[T(2.11±0.33)nmol/L、LH(6.17±2.08)U/L、FSH(2.01±0.37)mmol/L、TG(0.82±0.38)mmol/L、TC(3.44±0.95)mmol/L、LDL-C(2.22±0.35)mmol/L、HDL-C(1.37±0.41)mmol/L、FINS(12.75±6.33)μIU/ml、FPG(4.37±0.43)mmol/L、HOMA-IR(0.33±0.18)、AMH(5.03±1.66)ng/ml及TNF-α(0.85±0.27)pg/ml]比较,B组[T(2.41±0.63)nmol/L、LH(7.94±2.83)U/L、FSH(3.66±1.21)mmol/L、TG(1.03±0.49)mmol/L、TC(4.06±1.07)mmol/L、LDL-C(2.66±0.52)mmol/L、HDL-C(1.60±0.43)mmol/L、FINS(14.17±7.13)μIU/ml、FPG(5.23±0.77)mmol/L、HOMA-IR(0.55±0.29)、AMH(7.39±2.46)ng/ml及TNF-α(1.01±0.28)pg/ml]和C组[T(3.02±0.95)nmol/L、LH(10.15±2.77)U/L、FSH(4.45±1.34)mmol/L、TG(1.36±0.68)mmol/L、TC(4.88±1.33)mmol/L、LDL-C(3.02±0.64)mmol/L、HDL-C(1.89±0.45)mmol/L、FINS(15.37±7.66)μIU/ml、FPG(6.01±0.83)mmol/L、HOMA-IR(0.69±0.36)、AMH(8.55±2.77)ng/ml及TNF-α(1.20±0.30)pg/ml]水平均升高,且C组水平更高,差异均有统计学意义(F=18.690、25.414、56.377、10.825、17.098、24.794、13.705、6.586、57Objective To analyze the effect of ethinestradiol cyproterone on the treatment of infertility in patients with polycystic ovary syndrome(PCOS)with different anti-Mullerian hormone(AMH)expression levels.Methods 80 patients with PCOS and infertility who were admitted to Lishui Hospital of Traditional Chinese Medicine from May 2021 to October 2023 were selected as the study objects and grouped according to different AMH expression levels.They were divided into 35 patients with low AMH expression concentration(group B)and 45 patients with high AMH expression concentration(group C).In addition,40 non-pregnant healthy women who underwent physical examination in this hospital during the same period were selected as group A.group B and group C were treated with ethinestradiol cyproterone,group A was not treated with any treatment.Sex hormones[testosterone(T),luteinizing hormone(LH)and follicle-stimulating hormone(FSH)],lipid metabolism[triglyceride(TG),cholesterol(TC),low density lipoprotein cholesterol(LDL-C)and high density lipoprotein cholesterol(HDL-C)]and glucose metabolism were compared in the 3 groups[fasting insulin(FINS),fasting blood glucose(FPG)and insulin resistance index(HOMA-IR)],tumor necrosis factor-α(TNF-α),AMH levels,pregnancy rate and ovulation rate.Results Before treatment,the levels of sex hormone,lipid metabolism,glucose metabolism,TNF-αand AMH were all in group A,It was lower than group B and group C,and the difference was statistically significant(all P<0.05).After treatment,the results were significantly lower than those of group A[T(2.11±0.33)nmol/L,LH(6.17±2.08)U/L,FSH(2.01±0.37)mmol/L,TG(0.82±0.38)mmol/L,TC(3.44±0.95)mmol/L,LDL-C(2.22±0.35)mmol/L,HDL-C (1. 37±0. 41) mmol/ L, FINS (12. 75±6. 33) μIU/ ml, FPG (4. 37±0. 43) mmol/ L, HOMA-IR (0. 33±0. 18), AMH (5. 03±1. 66) ng/ mland TNF-α (0. 85±0. 27) pg/ ml], group B [T (2. 41±0. 63) nmol/ L, LH (7. 94±2. 83) U/ L, FSH (3. 66±1. 21) mmol/ L, TG(1. 03±0. 49) mmol/ L, TC (4. 06±1. 07) mmol/ L, LDL-C (2. 66±0. 52) mmol/ L, H

关 键 词：炔雌醇环丙孕酮 抗苗勒管激素 多囊卵巢综合征 不孕患者 

分 类 号：R711.6[医药卫生—妇产科学]