25-OH-VD水平对多囊卵巢综合征患者人工授精妊娠结局的影响  

25-OH-VD level on pregnancy outcome in patients with polycystic ovary syndrome after artificial insemination

作　　者：陈秀改 孙云青 张玲 崔妍 朱明月 于璨 张志革 CHEN Xiugai;SUN Yunqing;ZHANG Ling;CUI Yan;ZHU Mingyue;YU Can;ZHANG Zhige(Department of Reproductive Medicine,Xingtai Central Hospital,Xingtai,Hebei,China,054000;Department of Obstetrics,Xingtai Central Hospital,Xingtai,Hebei,China,054000;Department of Gynecology,Xingtai Central Hospital,Xingtai,Hebei,China,054000)

机构地区：[1]邢台市中心医院生殖医学科,河北邢台054000 [2]邢台市中心医院产科,河北邢台054000 [3]邢台市中心医院妇科,河北邢台054000

出　　处：《分子诊断与治疗杂志》2025年第3期462-465,共4页Journal of Molecular Diagnostics and Therapy

基　　金：河北省重点研发计划项目(2022803D);邢台市重点研发计划自筹项目任务书(2022ZC149)。

摘　　要：目的探讨25-羟基维生素D(25-OH-VD)水平对多囊卵巢综合征(PCOS)患者人工授精(IUI)妊娠结局的影响。方法选取2022年6月至2023年6月于邢台市中心医院行人工授精的300例PCOS患者作为研究对象,收集所有研究对象的临床资料,均测定25-OH-VD水平,根据25-OH-VD水平将研究对象分为维生素D正常组(25-OH-VD≥50 nmol/L,n=194)和维生素D缺乏组(25-OH-VD<50 nmol/L,n=106);比较两组一般资料、人工授精妊娠结局,采用多因素Logistic回归分析探讨PCOS患者人工授精妊娠结局的影响因素。结果维生素D缺乏组患者抗苗勒管激素(AMH)低于维生素D正常组,差异有统计学意义(P<0.05)。维生素D缺乏组的临床妊娠率为10.38%(11/106),低于维生素D正常组的19.59%(38/194),差异有统计学意义(P<0.05),维生素D缺乏组的流产率为9.09%(1/11),高于维生素D正常组的0.00%(0/38),但两组流产率比较差异无统计学意义(P>0.05)。单因素分析显示:年龄、AMH、IUI日≥18 mm平均卵泡数、25-OH-VD水平是影响临床妊娠的因素(P<0.05)。多因素分析显示:年龄(OR=2.489,95%CI:1.388~4.464)、AMH(OR=2.305,95%CI:1.246~4.2656)、25-OH-VD水平(OR=2.798,95%CI:1.645~4.760)是PCOS患者人工授精临床妊娠结局的独立影响因素(P<0.05)。结论通过维持25-OH-VD水平正常可以增加PCOS人工授精患者临床妊娠率、降低流产率,改善临床妊娠结局;且年龄、AMH、25-OH-VD水平是PCOS患者人工授精临床妊娠结局的独立影响因素。Objective To investigate the effect of 25-hydroxyvitamin D(25-OH-VD)level on pregnancy outcomes in patients with polycystic ovary syndrome(PCOS)after artificial insemination(IUI).Methods 300 patients with PCOS who underwent artificial insemination at our hospital from June 2022 to June 2023 were selected as study subjects.Clinical data for all subjects were collected,and 25-OH-VD levels were measured.Based on the 25-OH-VD level,the subjects were divided into two groups:the normal vitamin D group(25-OH-VD≥50 nmol/L,n=194)and the vitamin D deficiency group(25-OH-VD<50 nmol/L,n=106).The general data and pregnancy outcomes of artificial insemination were compared between the two groups,and the influencing factors of pregnancy outcomes in PCOS patients undergoing artificial insemination were discussed through multivariate logistic regression analysis.Results The anti-Mullerian hormone(AMH)levels in the vitamin D deficiency group were lower than those in the vitamin D normal group(P<0.05).The clinical pregnancy rate in the vitamin D deficiency group was 10.38%(11/106),which was lower than the 19.59%(38/194)in the vitamin D normal group,and this difference was statistically significant(P<0.05).The miscarriage rate in the vitamin D deficiency group was 9.09%(1/11),higher than the 0.00%(0/38)in the vitamin D normal group,but there was no statistically significant difference in miscarriage rate between the two groups(P>0.05).Univariate analysis showed that age,AMH,IUI day≥18 mm average follicle number,and 25-OH-VD level were factors affecting clinical pregnancy(P<0.05).Multivariate analysis showed that age(OR=2.489,95%CI:1.388-4.464),AMH(OR=2.305,95%CI:1.246-4.2656),25-OH-VD level(OR=2.798,95%CI:1.645~4.760)were independent influencing factors for clinical pregnancy outcome in PCOS patients(P<0.05).Conclusion Maintaining a normal level of 25-OH-VD can increase the clinical pregnancy rate,reduce the abortion rate,and improve the clinical pregnancy outcome in PCOS patients.Moreover,age,AMH,and 25-OH-VD levels are indepen

关 键 词：25-羟基维生素D 多囊卵巢综合征 人工授精 妊娠结局 

分 类 号：R71[医药卫生—妇产科学]