抗苗勒管激素和甲状腺特异性抗体预测多囊卵巢综合征人工授精妊娠结局的价值  

Value of Anti-millerian hormone and thyroid specific antibodies in predicting pregnancy outcomes safter artificial insemination in polycystic ovary syndrome

作　　者：王小红[1] 王毓 吴敏云[1] WANG Xiao-hong;WANG Yu;WU Min-yun(Quzhou People's Hospital,Quzhou,Zhejiang 324000,China)

机构地区：[1]衢州市人民医院,浙江衢州324000

出　　处：《中国妇幼保健》2025年第7期1243-1246,共4页Maternal and Child Health Care of China

基　　金：浙江省衢州市指导性科技攻关项目(2021012)。

摘　　要：目的 探讨抗苗勒管激素(AMH)、甲状腺特异性抗体预测多囊卵巢综合征(PCOS)人工授精妊娠结局的价值。方法 选择2021年1月—2022年12月在衢州市人民医院进行人工授精的PCOS患者作为研究对象,根据3个人工授精周期后妊娠结局分为妊娠组39例和未妊娠组85例,比较两组临床资料,采用logistic回归模型分析PCOS人工授精妊娠结局的影响因素,采用受试者工作特征曲线(ROC)分析实验室指标预测PCOS人工授精妊娠结局的价值。结果 妊娠组患者年龄[(29.64±3.48)岁]、PCOS病程[(3.55±1.04)年]、中重度PCOS比例(43.59%)、AMH[(5.38±1.55)ng/ml]、TGAb[(2.02±0.47)IU/ml]及甲状腺过氧化物酶抗体(TPOAb)[(0.82±0.18)IU/ml]水平显著低于未妊娠组[(31.83±4.26)岁、(4.02±1.26)年、71.76%、(7.68±1.79)ng/ml、(2.91±0.71)IU/ml、(1.17±0.32)IU/ml],差异有统计学意义(P<0.05),Gn总剂量、Gn使用时间、雌二醇(E2)水平显著高于未妊娠组(P<0.05);logistic多因素回归分析显示,Gn总剂量、Gn使用时间、AMH、TGAb及TPOAb是PCOS人工授精妊娠结局的主要影响因素(P<0.05),年龄、PCOS病程、PCOS病情、E2与人工授精结局无显著关系(P>0.05);ROC分析结果显示,AMH、TGAb、TPOAb以及联合预测PCOS人工授精妊娠结局的AUC分别是0.754、0.748、0.778、0.874,联合预测价值显著高于单一指标。结论 AMH、TGAb、TPOAb预测PCOS人工授精妊娠结局有较好价值,可联合检测三者水平用于临床评估。Objective To investigate the value of anti-mullerian hormone(AMH)and thyroid specific antibody in predicting the pregnancy outcome of artificial insemination with polycystic ovary syndrome(PCOS).Methods PCOS patients who underwent artificial insemination in our hospital from January 2021 to December 2022 were selected as research objects.According to the pregnancy outcome after 3 cycles of artificial insemination,they were divided into the pregnant group(39 cases)and the non-pregnant group(85 cases),and the clinical data of the two groups were compared.Logistic regression was used to analyze the influencing factors of pregnancy outcome after artificial insemination of PCOS,and receiver operating characteristic curve(ROC)was used to analyze the value of laboratory indicators in predicting pregnancy outcome after artificial insemination of PCOS.Results The age,PCOS course,proportion of severe PCOS,AMH,thyroglobulin antibody(TGAb)and thyroperoxidase anti-body(TPOAb)levels in the pregnant group[(29.64±3.48)years old,(3.55±1.04)years,43.59%,(5.38±1.55)ng/ml,(2.02±0.47)IU/ml,(0.82±0.18)IU/ml]were significantly lower than those in the non-pregnant group[(31.83±4.26)years old,(4.02±1.26)years,71.76%,(7.68±1.79)ng/ml,(2.91±0.71)IU/ml,(1.17±0.32)IU/ml],the difference is statistically significant(P<0.05),the total Gn dose[(568.48±156.95)U],duration of GN[(9.15±2.77)d]and estrogen(E,)level[(75.16±13.99)pg/ml]were significantly higher than those of non-pregnant group[(479.73±125.60)U,(7.86±2.64)d,(57.40±10.25)pg/ml],the difference is statistically significant(P<0.05).Logistic regression analysis showed that the total Gn dose,duration of Gn,AMH,TGAb and TPOAb were the main influencing factors for pregnancy outcome of artificial insemination(P<0.05),and the age,PCOS course,PCOS condition and E2 had no significant relationship with the outcome of artificial insemination(P<0.05).ROC analysis results showed that the AUC of AMH,TGAb,TPOAb and combined prediction of pregnancy outcome of artificial insemination of PCO

关 键 词：多囊卵巢综合征 人工授精 妊娠结局 抗苗勒管激素 甲状腺特异性抗体 

分 类 号：R711.75[医药卫生—妇产科学]