血清SF、SAA水平与肥胖型多囊卵巢综合征合并不孕患者卵巢血流动力学的关系  

Relationship between serum ferritin(SF)and serum amyloid A(SAA)levels and ovarian hemodynamics in infertile patients with obese polycystic ovary syndrome(PCOS)

作　　者：李廷雨 沈鉴东[2] 石恒 陆敬巧 LI Tingyu;SHEN Jiandong;SHI Heng;LU Jingqiao(Department of Gynecology,the First People's Hospital of Suqian,Suqian Jiangsu 223800,China;Department of Reproductive Medicine,Jiangsu Provincial People's Hospital,Nanjing 210029,China;Department of Reproductive Medicine,the First People's Hospital of Suqian,Suqian Jiangsu 223800,China)

机构地区：[1]宿迁市第一人民医院妇科,江苏宿迁223800 [2]江苏省人民医院生殖医学科,南京210029 [3]宿迁市第一人民医院生殖医学科,江苏宿迁223800

出　　处：《新疆医科大学学报》2025年第3期311-316,共6页Journal of Xinjiang Medical University

基　　金：江苏省基础研究计划项目(BK20201488)。

摘　　要：目的探讨血清铁蛋白(SF)、血清淀粉样蛋白A(SAA)与肥胖型多囊卵巢综合征(PCOS)合并不孕患者卵巢血流动力学的关系,并分析预后影响因素。方法以150例PCOS不孕患者为研究对象,均于2021年5月至2024年5月在本院接受治疗,根据体质指数(BMI)将研究对象分为肥胖组(n=97)和非肥胖组(n=53)。检测两组患者血清SF、SAA水平及卵巢血流动力学指标[搏动指数(PI)、阻力指数(RI)],采用Spearman相关性分析SF、SAA与PI及RI的相关性。根据治疗后妊娠结局将肥胖组患者分为预后良好组(n=39)和预后不良组(n=58)。采用单因素和多因素Logistic回归分析肥胖型PCOS合并不孕患者预后的影响因素,绘制受试者工作特征(ROC)曲线分析SF、SAA对肥胖型PCOS合并不孕患者预后的预测价值。结果肥胖组患者血清SF、SAA水平高于非肥胖组(P<0.05)。肥胖组患者PI、RI高于非肥胖组(P<0.05)。Spearman相关性分析结果显示,肥胖型PCOS合并不孕患者的SF、SAA水平与PI、RI呈正相关(r=0.606、0.637、0.641、0.635,P均<0.05)。单因素分析结果显示,预后良好组与预后不良组在胰岛素抵抗指数(HOMA-IR)、黄体生成素(LH)、促卵泡生成素(FSH)、LH/FSH、PI、RI、SF、SAA方面差,异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,高HOMA-IR、LH/FSH、PI、RI、SF、SAA水平是肥胖型PCOS合并不孕患者预后不良的独立危险因素(P<0.05)。ROC分析结果显示,SF、SAA预测肥胖型PCOS合并不孕患者预后不良的曲线下面积(AUC)分别为0.826、0.791,二者联合的AUC值为0.852,联合预测价值高于两者单独预测(P<0.05)。结论肥胖型PCOS合并不孕患者SF、SAA水平与PI、RI呈正相关。SF、SAA水平可辅助预测肥胖型PCOS合并不孕患者预后不良,且联合预测效果更佳。Objective To investigate the relationship between serum ferritin(SF),serum amyloid A(SAA),and ovarian hemodynamics in infertile patients with obese polycystic ovary syndrome(PCOS),and to analyze the influencing factors of prognosis.Methods A total of 150 infertile patients with PCOS who received treatment in the hospital from May 2021 to May 2024 were recruited as the research subjects.According to the body mass index(BMI),the subjects were divided into an obese group(n=97)and a non-obese group(n=53).Serum levels of SF and SAA,as well as ovarian hemodynamic indices[pulsatility index(PI)and resistance index(RI)]were measured in both groups.Spearman's correlation analysis was used to explore the correlations between SF,SAA and PI,RI.Based on the pregnancy outcomes after the treatment,the patients in the obese group were classified into a good-prognosis group(n=39)and a poor-prognosis group(n=58).Univariate and multivariate Logistic regression analyses were conducted to identify the influencing factors of prognosis in infertile patients with obese PCOS.The receiver operating characteristic(ROC)curve was plotted to evaluate the predictive value of SF and SAA for the prognosis of the patients.Results The serum levels of SF and SAA in the obese group were higher than those in the non-obese group(P<0.05).The values of PI and RI in the obese group were also higher than those in the non-obese group(P<0.05).Spearman's correlation analysis indicated that in infertile patients with obese PCOS,the levels of SF and SAA were positively correlated with PI and RI(r=0.606,0.637,0.641,0.635;all P<0.05).Univariate analysis showed that there were statistically significant differences between the good-prognosis group and the poor-prognosis group in terms of homeostasis model assessment-insulin resistance(HOMA-IR),luteinizing hormone(LH),follicle-stimulating hormone(FSH),LH/FSH ratio,PI,RI,SF,and SAA(P<0.05).Multivariate Logistic regression analysis revealed that high levels of HOMA-IR,LH/FSH ratio,PI,RI,SFand SAA were independent risk

关 键 词：血清铁蛋白 血清淀粉样蛋白A 肥胖 多囊卵巢综合征 不孕 卵巢血流动力学 预后 

分 类 号：R71[医药卫生—妇产科学]