摘要
目的 探讨卵巢子宫内膜异位囊肿患者血清表达抗苗勒管激素(AMH)情况及其临床意义.方法 选取2014年3月至2016年6月我院妇产科收治的51例卵巢子宫内膜异位囊肿患者(观察组)以及同期体检科确诊的35名正常妇女(对照组)作为研究对象.观察组患者均接受腹腔镜卵巢子宫内膜异位囊肿剥除术治疗,采用酶联免疫吸附试验(ELISA)检测对照组体检时以及观察组术前、术后1个月、术后3个月血清AMH并进行分析.结果 (1)观察组术前血清AMH水平(2.45±0.68)μg/L显著低于对照组体检时的血清AMH(3.75±0.80)μg/L,差异有统计学意义(t=7.8604,P=0.0000).(2)年龄≥35岁组患者术前血清AMH水平(1.76±0.57)μg/L显著低于年龄<35岁组(3.61±0.88)μg/L,差异有统计学意义(t=9.1249,P=0.0000);病程≥12个月组患者术前血清AMH水平(2.03±0.64)μg/L显著低于病程<12个月组(3.98±0.91)μg/L,差异有统计学意义(t=8.1408,P=0.0000);伴痛经组患者术前血清AMH水平(1.65±0.53)μg/L显著低于未伴痛经组(3.91±0.84)μg/L患者,差异有统计学意义(t=11.7861,P=0.0000);双侧病灶组患者术前血清AMH水平(2.01±0.68)μg/L显著低于单侧病灶组(2.84±0.72)μg/L,差异有统计学意义(t=4.2174,P=0.0001);囊肿直径≥5.0 cm组患者术前血清AMH水平(2.52± 0.81)μg/L 与直径<5.0 cm 组(2.39 ± 0.50)μg/L 患者相比差异无统计学意义(t=0.8411,P=0.4029).(3)观察组术后3个月血清AMH水平(2.45± 0.68)μg/L显著低于术前(1.81 ±0.55)μg/L,差异有统计学意义(t=24.3657,P=0.0000).结论 卵巢子宫内膜异位囊肿患者血清AMH水平呈低表达状态,且其与患者年龄、病程、痛经史、病灶部位等密切相关.腹腔镜卵巢子宫内膜异位囊肿剥除术可以降低卵巢子宫内膜异位囊肿患者的卵巢储备能力.
Objective To investigate the expression of anti mullerian hormone(AMH)in the serum of patients with ovarian endometriosis cyst and its clinical significance.Methods Fifty-one cases of ovarian endometriosis cyst from March 2014 to June 2016 in Maternal and Child Health Hospital Affiliated to Southern Medical University(observation group)and thirty-five cases of normal women who were diagnosed through physical examination(control group)were selected as the research objects.The observation group patients received laparoscopic ovarian endometriosis cystectomy treatment,enzyme-linked immunosorbent assay(ELISA) was applied to detect and analyze serum AMH in the control group at physical examination and in the observation group before surgery and at 1 month,3 months after surgery.Results (1)The preoperative serum AMH level of the observation group was significantly lower than that of the control group,the difference was statistically significant((2.45±0.68)μg/L vs.(3.75±0.80)μg/L,t=7.8604,P=0.0000).(2)Serum AMH level in the groups where the ages were above 35years was significantly lower than that of the age less than 35 group( (1.76±0.57)μg/L vs.(3.61±0.88)μg/L,t=9.1249,P=0.0000); the preoperative serum AMH level in the group where disease course was more than 12 months was significantly lower than that of the disease course less than 12 months group((2.03 ± 0.64)μg/L vs.(3.98 ± 0.91)μg/L,t=8.1408,P=0.0000); the preoperative serum AMH level in patients with dysmenorrhea was significantly lower than that of patients without dysmenorrhea((1.65±0.53)μg/L vs.(3.91±0.84)μg/L,t=11.7861,P=0.0000),the preoperative serum AMH level in the bilateral lesion group was significantly lower than that of the unilateral lesion((2.01±0.68) μg/L vs.(2.84±0.72)μg/L,t=4.2174,P=0.0001); there was no significant difference in the preoperative serum AMH level between patients with<5.0 cm diameter cyst and patients with smaller cyst((2.52 + 0.81)μg/L vs.(2.39 + 0.50)μg/L,t=0.8411,P=0.4029).The serum AMH level in the observation group at 3 months after surgery was significantly lower than that before surgery((2.45±0.68)μg/L vs.(1.81± 0.55) μg/L,t=24.3657,P=0.0000).Conclusion The expression of serum AMH level in patients with ovarian endometriosis is low,and it is closely related to the age,course of disease,history of dysmenorrhea and the location of the lesion.Laparoscopic ovarian cystectomy may reduce ovarian reserve capacity in patients with ovarian endometriosis.
出处
《中国综合临床》
2017年第12期1131-1134,共4页
Clinical Medicine of China
