口服葡萄糖耐量试验异常对PCOS患者AIH结局的影响
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摘要
目的探讨口服葡萄糖耐量试验(OGTT)异常对多囊卵巢综合征(PCOS)患者夫精人工授精(AIH)妊娠结局的影响。方法连续入选2015年1月—2017年6月于莆田学院附属医院生殖中心行AIH助孕的PCOS患者97例,228个周期。根据口服葡萄糖耐量试验结果将PCOS患者分为两组,糖代谢正常组,糖代谢异常组。比较两组患者糖代谢及妊娠结局的差异。结果 PCOS患者糖代谢正常组占55.67%(54/97),糖代谢异常发生率高达44.33%(43/97)。糖代谢正常组AIH临床妊娠率显著高于糖代谢异常组(P <0.05),糖代谢异常组生化妊娠率及流产率较正常组升高,但均不具显著性差异(P>0.05)。结论 PCOS合并不孕症患者糖代谢异常发生率较高,可利用OGTT筛查此类患者。口服葡萄糖试验异常对PCOS患者AIH临床妊娠产生负面影响,治疗前给予预处理有望改善其妊娠结局。
Objective To study the impact of oral glucose tolerance test abnormality on AIH outcomes in patients with PCOS. Methods A total of 97 cases women with PCOS undergone AIH for 228 cycles were administrated in the Reproductive Medicine Center of Affiliated Hospital of Putian University from January 2015 to June 2017. According to OGTT results, PCOS patients were divided into normal glucose test group and abnormal glucose test group. Results The incidence of normal glucose test group in patients with PCOS was 55.67% (54/97), and the incidence of abnormal glucose test group was up to 44.33% (43/97). Clinical pregnancy rate in normal glucose test group were significantly higher than abnormal glucose test group (P < 0.05). Biochemical pregnancy rate and abortion rate in abnormal glucose test group were higher than the normal glucose test group, but there were no significant differences (P > 0.05). Conclusion Patients with PCOS have a greater incidence of glycometabolism disorder. OGTT is screened for patients with PCOS. Oral glucose tolerance test abnormality have a detrimental effect on AIH outcomes in patients with PCOS, preconditioning is helpful to improve the clinical outcomes.
Objective To study the impact of oral glucose tolerance test abnormality on AIH outcomes in patients with PCOS. Methods A total of 97 cases women with PCOS undergone AIH for 228 cycles were administrated in the Reproductive Medicine Center of Affiliated Hospital of Putian University from January 2015 to June 2017. According to OGTT results, PCOS patients were divided into normal glucose test group and abnormal glucose test group. Results The incidence of normal glucose test group in patients with PCOS was 55.67% (54/97), and the incidence of abnormal glucose test group was up to 44.33% (43/97). Clinical pregnancy rate in normal glucose test group were significantly higher than abnormal glucose test group (P < 0.05). Biochemical pregnancy rate and abortion rate in abnormal glucose test group were higher than the normal glucose test group, but there were no significant differences (P > 0.05). Conclusion Patients with PCOS have a greater incidence of glycometabolism disorder. OGTT is screened for patients with PCOS. Oral glucose tolerance test abnormality have a detrimental effect on AIH outcomes in patients with PCOS, preconditioning is helpful to improve the clinical outcomes.
引文
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[11]葛红山,李晓茹,张帆,等.抑制线粒体氧化磷酸化活性对卵子体外成熟、授精及发育的影响[J].北京大学学报(医学版),2013,45(6):864-868.
[12]管海云,张炜.多囊卵巢综合征对子宫内膜容受性的影响[J].生殖医学杂志,2016,25(12):1122-1125.
[13]高婧,周莉,陈慧,等.口服葡萄糖耐量试验和胰岛素释放试验在多囊卵巢综合征患者中的临床应用[J].生殖医学杂志,2016,23(6):505-510.
[14]Kazerooni T,Ghaffarpasand F, Asadi N, et al.Correlation between thrombophilia and recurrent pregnancy loss in patients with polycystic ovary syndrome:a comparative study[J]. Journal of the Chinese Medical Assiciation:JCMA,2013,76(5):282-288.
[15]杨丸,王海燕.多囊卵巢综合征与复发性流产[J].中国计划生育和妇产科,2017,9(10):1-5.
[16]Kaur R Gupta K, Endocrine dysfunction and recurrent spontaneous abortion:An overview[J]. International Journal of Applied&Basic Medical Research,2016,6(2):79-83.
[2]乔杰,李蓉,李莉,等.多囊卵巢综合征流行病学研究[J].中国实用妇科和产科杂志,2013,29(11):849-852.
[3]Salley KE,Wickham EP,Cheang KI,et al. Glucose intolerance in polycystic ovary syndrome-a position statement of the Androgen Excess Society[J]. J Clin Endocrinol Metab,2007,92(12):4546-4556.
[4]丁楠,王芳,简启亮,等.不同剂量来曲唑对多囊卵巢综合征患者疗效的Meta分析[J].生殖与避孕,2015,35(9):626-634.
[5]Ghahiri A,Mogharehabed N,Mamourian M. Letrozole as the firstline treatment of infertile women with poly cystic ovarian syndrome(PCOS)compared with clomiphene citrate:A clinical trial[J]. Adv Biomed Res,2016,29(5):6.
[6]罗小欢,夏薇,苏宁,等.不同促排卵方案用于PCOS患者宫腔内人工授精的临床效果分析[J].中国计划生育学杂志,2015,23(4):246-251.
[7]Alberti KG,Zimmet P,Shaw J. International Diabetes Federation:a consensus on type 2 diabetes prevention[J]. Diabet Med,2007,24(5):451-463.
[8]杨蕊,金达莱,王颖,等.多囊卵巢综合征患者不同糖代谢状态的临床分析[J].生殖与避孕,2014,34(4):273-280.
[9]刘丽华.糖脂代谢紊乱与多囊卵巢综合征相关性分析[J].江西医药,2016,51(8):808-810.
[10]王文文,周易,王丽亚,等.胰岛素释放试验异常对PCOS患者IVF/ICSI结局的预测作用[J],生殖医学杂志,2017,26(7):685-688.
[11]葛红山,李晓茹,张帆,等.抑制线粒体氧化磷酸化活性对卵子体外成熟、授精及发育的影响[J].北京大学学报(医学版),2013,45(6):864-868.
[12]管海云,张炜.多囊卵巢综合征对子宫内膜容受性的影响[J].生殖医学杂志,2016,25(12):1122-1125.
[13]高婧,周莉,陈慧,等.口服葡萄糖耐量试验和胰岛素释放试验在多囊卵巢综合征患者中的临床应用[J].生殖医学杂志,2016,23(6):505-510.
[14]Kazerooni T,Ghaffarpasand F, Asadi N, et al.Correlation between thrombophilia and recurrent pregnancy loss in patients with polycystic ovary syndrome:a comparative study[J]. Journal of the Chinese Medical Assiciation:JCMA,2013,76(5):282-288.
[15]杨丸,王海燕.多囊卵巢综合征与复发性流产[J].中国计划生育和妇产科,2017,9(10):1-5.
[16]Kaur R Gupta K, Endocrine dysfunction and recurrent spontaneous abortion:An overview[J]. International Journal of Applied&Basic Medical Research,2016,6(2):79-83.