联合检测血清抗苗勒管激素和维生素D表达水平对多囊卵巢综合征患者妊娠结局的预测价值  

Predictive value of combined detection of serum serum anti-Müllerian hormone and vitamin D expression levels for pregnancy outcome in patients with polycystic ovary syndrome

作　　者：徐娇 饶红云 陈茹 Xu Jiao;Rao Hongyun;Chen Ru(Department of Gynaecology and Obstetrics,the People′s Hospital of Hebi,Hebi 458030,China;Department of Reproductive Medicine,the People′s Hospital of Hebi,Hebi 458030,China)

机构地区：[1]鹤壁市人民医院妇产科,鹤壁458030 [2]鹤壁市人民医院生殖医学科,鹤壁458030

出　　处：《实用医技杂志》2025年第4期294-298,共5页Journal of Practical Medical Techniques

摘　　要：目的探讨多囊卵巢综合征(PCOS)患者血清抗苗勒管激素(AMH)、维生素D表达水平对妊娠结局的预测价值。方法回顾性分析鹤壁市人民医院2022年3月至2024年3月收治的100例PCOS患者临床资料,所有患者均进行炔雌醇环丙孕酮联合二甲双胍治疗,于第4个月经周期进行枸橼酸氯米芬促排。以妊娠结局为金标准,妊娠结局良好患者(70例)为妊娠结局良好组,妊娠结局不良患者(30例)为妊娠结局不良组。另选取同期50例非多囊备孕女性作为对照组,比较3组患者一般资料、胎儿预后情况、血清AMH、25-羟维生素D(25-(OH)D水平),计算AMH、25-(OH)D单一及联合的预测价值。结果妊娠结局良好组与妊娠结局不良组AMH高于对照组,25-(OH)D水平均明显低于对照组(P<0.05)。且妊娠结局良好组与妊娠结局不良组指标对比差异有统计学意义(P<0.05)。妊娠结局良好组年龄、体质指数(BMI)均低于妊娠结局不良组(P<0.05)。多因素Cox回归分析显示AMH水平过高、25-(OH)D水平过低均是PCOS患者不良妊娠结局的独立危险因素(P<0.05)。AMH、25-(OH)D联合检测曲线下面积(AUC)值高于单项检测(AUC=0.977,P<0.05)。结论联合检测血清AMH、VD水平对PCOS患者妊娠结局的预测价值较高,可作为临床评估妊娠情况的辅助检测指标。Objective To explore the predictive value of serum anti-Müllerian hormone(AMH)and vitamin D(VD)levels for pregnancy outcomes in patients with polycystic ovary syndrome(PCOS).Methods A retrospective analysis was conducted on 100 cases of clinical data of PCOS patients admitted to Hebi People′s Hospital from March 2022 to March 2024.All patients were treated with ethinylestradiol and cyproterone acetate combined with metformin,and clomiphene citrate was used for ovulation induction in the fourth menstrual cycle.The patients with good pregnancy outcomes(70 cases)were classified as the good pregnancy outcome group,and those with poor pregnancy outcomes(30 cases)were classified as the adverse pregnancy outcome group.Another 50 non-PCOS women preparing for pregnancy during the same period were selected as the control group.General data,fetal prognosis,serum AMH,and 25-(OH)D levels of the three groups were compared,and the predictive value of AMH and 25-(OH)D alone and in combination was calculated.Results The AMH levels in the good pregnancy outcome group and the adverse pregnancy outcome group were higher than those in the control group,while the 25-(OH)D levels were significantly lower than those in the control group(P<0.05).There were significant differences in the indicators between the good pregnancy outcome group and the adverse pregnancy outcome group(P<0.05).The age and BMI of the good pregnancy outcome group were lower than those of the adverse pregnancy outcome group(P<0.05).Multivariate Cox regression analysis showed that high AMH levels and low 25-(OH)D levels were independent risk factors for adverse pregnancy outcomes in PCOS patients(P<0.05).The AUC value of combined detection of AMH and 25-(OH)D was higher than that of single detection(AUC=0.977,P<0.05).Conclusion The combined detection of serum AMH and VD levels has a high predictive value for pregnancy outcomes in PCOS patients and can be used as an auxiliary detection index for clinical pregnancy assessment.

关 键 词：多囊卵巢综合征 抗苗勒管激素 维生素D 妊娠结局 

分 类 号：R711.75[医药卫生—妇产科学]