绝经过渡期妇女血清抑制素水平的研究  

Study on serum inhibin concentrations in women during menopausal transition

作　　者：张以文[1] 陈蔚林[1] 郁琦[1] 宋耀红[2] 周京[1] 张德永[1] 

机构地区：[1]中国医学科学院中国协和医科大学北京协和医院妇产科,100730 [2]中国医学科学院中国协和医科大学北京协和医院检验科,100730

出　　处：《中华妇产科杂志》2003年第2期98-101,共4页Chinese Journal of Obstetrics and Gynecology

摘　　要：目的　分析绝经过渡期妇女血清抑制素A(Inh A)、抑制素B(Inh B)水平的变化及其与其他生殖激素水平变化的时间关系。方法　测定 10例正常育龄妇女月经周期各期血清Inh A、Inh B水平 ;测定 40例绝经过渡期妇女月经周期第 3天的血清Inh B、促卵泡激素 (FSH)、促黄体生成素(LH)、雌二醇 (E2 )水平 ,经前 5～ 9d(经前期 )血清Inh A、孕酮 (P)水平 ;测定 10例绝经后妇女的血清Inh A、Inh B、FSH、E2 水平。分析各项激素水平变化之间的时间关系。结果　育龄妇女月经周期中Inh A、Inh B水平的变化曲线各不相同。绝经过渡期妇女中 ,黄体功能正常者占 48% ,经前期Inh A水平低于育龄妇女 ,分别为 ( 2 4 7± 13 0 )及 ( 42 9± 12 1)ng/L ,两者比较 ,差异有显著性 (P =0 0 17) ,Inh B水平改变差异无显著性 (P >0 0 5 ) ;黄体功能不足与无排卵者的Inh A水平进一步显著下降 ,分别为 ( 12 4± 10 2 )及 ( 5 3± 3 8)ng/L(P分别为 0 0 3 3及 <0 0 0 0 1) ,绝经后妇女则皆未检出。与育龄妇女比较 ,月经周期第 3天Inh B水平的下降仅在无排卵与绝经后妇女差异有极显著性 (P =0 0 0 1)。月经周期第 3天 ,FSH≥ 10IU/L者Inh B水平显著低于FSH <10IU/L者 ,分别为 ( 16 2± 4 0 )及 ( 62 0±43 8)ng/L(P <0 0Objective To investigate the changes of serum inhibin(Inh)-A,Inh-B concentrations during menopausal transition and the time relationship between changes of serum Inh-A, Inh-B and other reproductive hormone levels. Methods Serum Inh-A, Inh-B concentrations were measured by Serotec modified two-site enzyme immunoassay during different phases of normal menstrual cycle in 10 healthy reproductive women, any time of 10 postmenopausal women. So did the serum Inh-A on 5-9 days prior to next period(premenstrual phase) and Inh-B determinations on the 3rd day of menstrual cycle in 40 women of age 43-52 (menopausal transition group). In addition, serum follicle stimulating hormone(FSH), luteinizing hormone(LH), estradiol(E 2), progesterone(P) levels were also determined when necessary for the purpose of analysis. Results The fluctuation patterns of serum Inh-A, Inh-B concentrations during normal menstrual cycle were completely different.About 48% of women during menopausal transition had normal luteal function as shown by the P levels during the premenstrual phase. The only significant change in these women as compared with the young was decrease of Inh-A concentration [(24.7±13.0) ng/L Vs (42.9±12.1)ng/L,P=0.017] in the same phase. Further significant declines of serum Inh-A levels were seen in the luteal phase defect (LPD) and anovulatory (AOV) groups [(12.4 ±10.2) ng/L and (5.3±3.8)ng/L,P=0.033, P<0.000 1 respectively], until undetectable in the postmenopausal group. The day 3 Inh-B levels tended to decrease in the normal luteal and LPD groups, became undetectable in the AOV and postmenopausal groups (P=0.001). Day 3 Inh-B levels was significantly lower in women with day 3 FSH≥10 IU/L than those with <10 IU/L [(16.2±4.0) ng/L Vs (62.0±43.8)ng/L]. The elevation of day 3 FSH, LH levels was not significant until the AOV group (P=0.009,P=0.027 respectively), and the drop of E 2 levels until the postmenopausal group (P<0.001).Conclusions It is suggested that serum reproductive hormones should be measured

关 键 词：绝经前期 抑制素类 卵巢贮备 月经周期 

分 类 号：R711[医药卫生—妇产科学]