抗苗勒管激素在优生优育检测应用中的临床研究
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摘要
目的通过将抗苗勒管激素(AMH)与性激素六项进行比较,进一步验证抗苗勒管激素在优生优育检查中的临床应用优越性。方法选取2015年1月至2017年1月就诊的246例因卵巢功能导致的育龄期不孕症女性为研究组,结合研究组患者的年龄,将研究组患者分为低龄组和高龄组,并选取140例孕龄期健康者作为对照组,分别观察研究组和对照组及低龄组和高龄组患者血清AMH、促黄体生成素(LH)、促卵泡成熟激素(FSH)、垂体泌乳素(PRL)、雌二醇(E2)、睾酮(T)、孕酮(P)水平,AMH在3个月内的变化情况及不同年龄患者AMH水平以判断血清AMH在优生优育检测中的临床应用价值及相关影响因素。结果研究组患者AMH及E2水平明显低于对照组(P <0. 05),FSH、LH和PRL水平明显高于对照组(P <0. 05),P和T未见明显变化(P> 0. 05),且研究组患者血清AMH在3个月内波动幅度均明显大于对照组,差异有统计学意义(P <0. 05);高龄组患者AMH及E2水平低于低龄患者(P <0. 05),FSH、LH和PRL水平高于低龄患者,差异有统计学意义(P <0. 05);且上述比较中患者AMH数值变化较其他指标敏感性强(P <0. 01),其中高龄患者波动幅度大于低龄患者,差异有统计学意义(P <0. 05)。结论血清AMH、LH、FSH、PRL和E2可作为孕龄期女性卵巢储备功能下降和不孕症诊断的指标性依据,且血清AMH可作为早期判断及诊断卵巢储备功能下降和不孕症的可靠依据。
Objective To further verify the advantages of the clinical application of anti-mullerian hormone in detection of good prenatal and postnatal care by comparing it with the six-items sex hormone indexes. Methods A total of 246child-bearing age women with infertility caused by hypofunction of ovary who were treated in our hospital from January 2015 to January 2016 were enrolled as research group,according to the subject's age,they were divided into low age group and high age group,moreover,the other 140 healthy child-bearing age women were enrolled as control group. The changes of serum levels of anti-mullerian hormone( AMH),luteinizing hormone( LH),follicle stimulating hormone( FSH),pituitary prolactin( PRL),estradiol( E2),testosterone( T),progesterone( P) within 3 months were observed to evaluate the application value of AMH in detection of good prenatal and postnatal care and related influencing factors. Results The levels of AMH and E2 in research group were significantly lower than those in control group( P < 0. 05),and the levels of FSH,LH and PRL were significantly higher than those in control group( P < 0. 05),however,there were no significant differences in the levels of P and T between the two groups( P > 0. 05). Moreover the fluctuation extent within 3 months in research group was more significant than that in control group( P < 0. 05). Moreover the levels of AMH and E2 in high age group were significantly lower than those in low age group( P < 0. 05),however,the levels of FSH,LH and PRL in high age group were significantly higher than those in low age group( P < 0. 05),moreover,the sensitivity of AMH was the highest in these indexes,in which,the fluctuation extent in high age group was more significant than that in low age group( P < 0. 05). Conclusion The serum levels of AMH,LH,FSH,PRL and E2 can be regarded as the indexes to diagnose hypofunction of ovary and infertility in child-bearing age women,moreover,the serum levels of AMH can be regarded as reliable basis to diagnose early the hypofunction of ovary and infertility in child-bearing age women.
Objective To further verify the advantages of the clinical application of anti-mullerian hormone in detection of good prenatal and postnatal care by comparing it with the six-items sex hormone indexes. Methods A total of 246child-bearing age women with infertility caused by hypofunction of ovary who were treated in our hospital from January 2015 to January 2016 were enrolled as research group,according to the subject's age,they were divided into low age group and high age group,moreover,the other 140 healthy child-bearing age women were enrolled as control group. The changes of serum levels of anti-mullerian hormone( AMH),luteinizing hormone( LH),follicle stimulating hormone( FSH),pituitary prolactin( PRL),estradiol( E2),testosterone( T),progesterone( P) within 3 months were observed to evaluate the application value of AMH in detection of good prenatal and postnatal care and related influencing factors. Results The levels of AMH and E2 in research group were significantly lower than those in control group( P < 0. 05),and the levels of FSH,LH and PRL were significantly higher than those in control group( P < 0. 05),however,there were no significant differences in the levels of P and T between the two groups( P > 0. 05). Moreover the fluctuation extent within 3 months in research group was more significant than that in control group( P < 0. 05). Moreover the levels of AMH and E2 in high age group were significantly lower than those in low age group( P < 0. 05),however,the levels of FSH,LH and PRL in high age group were significantly higher than those in low age group( P < 0. 05),moreover,the sensitivity of AMH was the highest in these indexes,in which,the fluctuation extent in high age group was more significant than that in low age group( P < 0. 05). Conclusion The serum levels of AMH,LH,FSH,PRL and E2 can be regarded as the indexes to diagnose hypofunction of ovary and infertility in child-bearing age women,moreover,the serum levels of AMH can be regarded as reliable basis to diagnose early the hypofunction of ovary and infertility in child-bearing age women.
引文
1张亚真,高雯,胡新东.炔雌醇环丙孕酮和二甲双胍联合治疗多囊卵巢综合征合并不孕症的效果分析.河南医学研究,2018,27:846-848.
2 Zegershochschild F,Adamson GD,De Mouzon J,et al.The International Committee for Monitoring Assisted Reproductive Technology(ICMART)and the World Health Organization(WHO)Revised Glossary on ARTTerminology,2009.Fertility and Sterility,2009,92:1520-1524.
3孙素丽,李宏毅,李歆,等.孕妇俱乐部健康教育与个体化营养指导相结合对妊娠结局的影响.河北医药,2016,38:1581-1584.
4 Nelson SM.Biomarkers of ovarian response:current and future applications.Fertil Steril,2013,99:963-969.
5杨霞,岳丰,孙小燕.辅助生殖技术治疗高龄不孕症患者妊娠丢失的危险因素分析.中国妇幼保健,2018,33:623-625.
6郑群,程兆俊,邹立波,等.不孕患者年龄因素与辅助生殖技术结局相关性分析.医药前沿,2016,6:186-187.
7王茜,孙健,李秀伶.血清抗苗勒管激素检测与优生优育的研究.标记免疫分析与临床,2016,23:1099-1100.
8谢幸,苟文丽主编.妇产科学.第8版.北京:人民卫生出版社,2013.69.
9李土珍,刘传勇,杨洁.不孕症患者血清性激素六项检测结果分析.中国实用医药,2018,13:78-79.
10孙丽君,冯营营,胡继君,等.卵巢正常反应不孕症患者体外受精不同长方案促排卵效果的研究.中华生殖与避孕杂志,2017,37:361-365.
11杨清华.探讨人绝经期尿促性腺激素联合达英-35治疗对多囊卵巢综合征不孕症患者排卵情况及妊娠率的影响.黑龙江医学,2018,42:55-56.
12张励.中西医结合治疗排卵障碍性不孕临床观察.实用中医药杂志,2018,34:229-230.
13孙文燕,邵云蕾,赖红梅.CD38和CD138在合并慢性子宫内膜炎不孕症患者中的诊疗价值探讨.基础医学论坛,2017,21:2886-2887.
14苏悦,顾扬,黄永生,等.卵巢早衰治疗过程中随访血清抗苗勒管激素和基础性激素水平的临床意义.实用妇科内分泌杂志,2018,5:3-6.
15叶虹.高血清抗苗勒管激素水平就是卵巢高反应吗?生殖医学杂志,2017,26:1088-1090.
16李强,邹存华,田向文.克龄蒙对早发性卵巢功能不全病人血清抗苗勒管激素影响及意义.齐鲁医学杂志,2017,32:462-466.
17 Steruli l,Fraisse T.Serum antimullerian hormone levels remain stable throughout the menstrual cycle and after oral or vaginal administration of synthetic sex steroids.Fertile Sterile,2008,90:395-400.
18吕兆祺.血清抗苗勒管激素检测在多囊卵巢综合征中的临床应用分析.基层医学论坛,2018,22:635-636.
19董玉姣.调经汤联合雌二醇/雌二醇地屈孕酮复合片治疗肾阴虚型卵巢储备功能下降疗效观察.现代中西医结合杂志,2018,27:862-865.
2 Zegershochschild F,Adamson GD,De Mouzon J,et al.The International Committee for Monitoring Assisted Reproductive Technology(ICMART)and the World Health Organization(WHO)Revised Glossary on ARTTerminology,2009.Fertility and Sterility,2009,92:1520-1524.
3孙素丽,李宏毅,李歆,等.孕妇俱乐部健康教育与个体化营养指导相结合对妊娠结局的影响.河北医药,2016,38:1581-1584.
4 Nelson SM.Biomarkers of ovarian response:current and future applications.Fertil Steril,2013,99:963-969.
5杨霞,岳丰,孙小燕.辅助生殖技术治疗高龄不孕症患者妊娠丢失的危险因素分析.中国妇幼保健,2018,33:623-625.
6郑群,程兆俊,邹立波,等.不孕患者年龄因素与辅助生殖技术结局相关性分析.医药前沿,2016,6:186-187.
7王茜,孙健,李秀伶.血清抗苗勒管激素检测与优生优育的研究.标记免疫分析与临床,2016,23:1099-1100.
8谢幸,苟文丽主编.妇产科学.第8版.北京:人民卫生出版社,2013.69.
9李土珍,刘传勇,杨洁.不孕症患者血清性激素六项检测结果分析.中国实用医药,2018,13:78-79.
10孙丽君,冯营营,胡继君,等.卵巢正常反应不孕症患者体外受精不同长方案促排卵效果的研究.中华生殖与避孕杂志,2017,37:361-365.
11杨清华.探讨人绝经期尿促性腺激素联合达英-35治疗对多囊卵巢综合征不孕症患者排卵情况及妊娠率的影响.黑龙江医学,2018,42:55-56.
12张励.中西医结合治疗排卵障碍性不孕临床观察.实用中医药杂志,2018,34:229-230.
13孙文燕,邵云蕾,赖红梅.CD38和CD138在合并慢性子宫内膜炎不孕症患者中的诊疗价值探讨.基础医学论坛,2017,21:2886-2887.
14苏悦,顾扬,黄永生,等.卵巢早衰治疗过程中随访血清抗苗勒管激素和基础性激素水平的临床意义.实用妇科内分泌杂志,2018,5:3-6.
15叶虹.高血清抗苗勒管激素水平就是卵巢高反应吗?生殖医学杂志,2017,26:1088-1090.
16李强,邹存华,田向文.克龄蒙对早发性卵巢功能不全病人血清抗苗勒管激素影响及意义.齐鲁医学杂志,2017,32:462-466.
17 Steruli l,Fraisse T.Serum antimullerian hormone levels remain stable throughout the menstrual cycle and after oral or vaginal administration of synthetic sex steroids.Fertile Sterile,2008,90:395-400.
18吕兆祺.血清抗苗勒管激素检测在多囊卵巢综合征中的临床应用分析.基层医学论坛,2018,22:635-636.
19董玉姣.调经汤联合雌二醇/雌二醇地屈孕酮复合片治疗肾阴虚型卵巢储备功能下降疗效观察.现代中西医结合杂志,2018,27:862-865.