[1]任 娟,苟 江.性激素结合球蛋白水平与多囊卵巢综合征合并不孕症患者黄体期短效促性腺激素释放激素激动剂长方案助孕结局相关性分析[J].陕西医学杂志,2021,50(4):435-438.[doi:DOI:10.3969/j.issn.1000-7377.2021.04.013]
　REN Juan,GOU Jiang.Correlation between SHBG level and the outcome of long-term assisted pregnancy plan of luteal phase short-acting GnRH-a in patients with PCOS and infertility[J].,2021,50(4):435-438.[doi:DOI:10.3969/j.issn.1000-7377.2021.04.013]
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性激素结合球蛋白水平与多囊卵巢综合征合并不孕症患者黄体期短效促性腺激素释放激素激动剂长方案助孕结局相关性分析
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
50
期数:
2021年4期
页码:
435-438
栏目:
临床研究
出版日期:
2021-04-05

文章信息/Info

Title:
Correlation between SHBG level and the outcome of long-term assisted pregnancy plan of luteal phase short-acting GnRH-a in patients with PCOS and infertility
作者:
任 娟; 苟 江
(西安市人民医院 西安市第四医院生殖医学中心,陕西 西安 710004)
Author(s):
REN Juan; GOU Jiang
(Reproductive Medicine Center,Xi'an People's Hospital,Xi'an 710004,China)
关键词:
不孕症;  多囊卵巢综合征;  性激素结合球蛋白;  体外受精-胚胎移植;  助孕;  长方案
Keywords:
Infertility;  Polycystic ovary syndrome;  Sex hormone binding protein;  In vitro fertilization-embryo transfer;  Assisted reproduction;  Long-term plan
分类号:
R 711.75
DOI:
DOI:10.3969/j.issn.1000-7377.2021.04.013
文献标志码:
A
摘要:
目的:探究性激素结合球蛋白(SHBG)水平与多囊卵巢综合征(PCOS)合并不孕症患者黄体期短效促性腺激素释放激素激动剂(GnRH-a)长方案助孕结局的相关性。方法:选择接受体外受精-胚胎移植(IVF-ET)助孕治疗且采用黄体期短效GnRH-a长方案的PCOS不孕症患者164例作为研究对象,并依据患者血清SHBG水平将患者分为正常水平组(SHBG水平≥18 nmol/L,93例)和低水平组(SHBG水平<18 nmol/L,71例),对比两组患者促排卵治疗前基础内分泌水平、促排卵情况和妊娠结局。结果:与正常水平组比,低水平组患者基础内分泌激素黄体生成素(LH)、睾酮(T)、黄体生成素/卵泡刺激素(LH/FSH)比值、脱氢表雄酮(DHEAS)和游离雄激素指数(FAI)水平均明显升高(均P<0.05),促排卵时促性腺激素(Gn)启动量、Gn天数、Gn总量明显增加,人绒毛膜促性腺激素(hCG)日雌二醇(E2)表达水平明显下降(均P<0.01),LH水平明显升高(P<0.05); 获卵数、成熟卵母细胞数(M Ⅱ)、受精卵数、卵裂数、优胚数、可移植胚胎数明显减少(均P<0.01),患者胚胎着床率和临床妊娠率明显下降,流产率明显升高(P<0.05)。结论:SHBG水平与PCOS不孕症患者机体内分泌激素异常密切相关,PCOS不孕症患者体内SHBG水平越低,黄体期短效GnRH-a长方案促排卵Gn用量越多,用时越长,且优胚率越低,患者IVF-ET助孕效果越差。
Abstract:
Objective:To explore the correlation between the level of sex hormone binding globulin(SHBG)and the outcome of a long-term plan of short-acting gonadotropin releasing hormone agonist(GnRH-a)in patients with polycystic ovary syndrome(PCOS)and infertility.Methods:164 patients with PCOS and infertility who received in vitro fertilization-embryo transfer(IVF-ET)and long-term assisted pregnancy plan of luteal phase short-acting GnRH-a were selected as the research objects.According to the patients' serum SHBG level,patients were divided into normal level group(SHBG≥18 nmol/L,93 cases)and low level group(SHBG<18 nmol/L,71 cases).The basic serum endocrine hormone levels,ovulation induction and pregnancy outcome were compared between the two groups.Results:Compared with normal level group,the levels of luteinizing hormone(LH),testosterone(T),medium luteinizing hormone/follicle stimulating hormone(LH/FSH)ratio,dehydroepiandrosterone(DHEAS)and free androgen index(FAI)in low level group were significantly increased(all P<0.05); the initial dose and total dose of Gn in the ovulation induction program were significantly higher,and the days of Gn was significantly prolonged,and the expression level of serum E2 on hCG day was significantly lower,and the expression level of LH was significantly higher(all P<0.05); the number of eggs obtained,the number of M II eggs,the number of fertilized eggs,the number of cleavage,the number of high-quality embryos,and the number of transferable embryos were decreased significantly,and the patients' embryo implantation rate and clinical pregnancy rate decreased significantly,and the abortion rate increased significantly(all P<0.05).Conclusion:The level of SHBG is closely related to the abnormal expression of endocrine hormones in patients with PCOS and infertility.The lower the SHBG level in patients with PCOS and infertility,the higher the dosage and days of Gn in luteal phase short-acting long-term plan,and the lower the rate of high-quality embryos,the worse the effect of IVF-ET.

参考文献/References:

[1] Yildiz BO,Bozdag G,Yapici Z,et al. Prevalence,phenotype and cardiometabolic risk of polycystic ovary syndrome under different diagnostic criteria[J]. Human Reproduction,2012,27(10):3067-3073.
[2] 李丽丽,师萍萍.血黄体生成素检测,经阴道超声卵泡监测联合不同促排卵方案对多囊卵巢综合征患者妊娠结局的影响[J].陕西医学杂志,2020,49(1):64-67.
[3] 赵甲维,李晓宁,黄炎清,等.多囊卵巢综合征病因学研究进展[J].国际生殖健康/计划生育杂志,2018,37(5):414-416.
[4] 战思恩,于 朝.性激素结合球蛋白与多囊卵巢综合征患者肥胖、血糖、胰岛素及性激素的相关性研究[J].中国妇幼保健,2019,34(10):2229-2231.
[5] 刘颖华,侯丽辉,徐 芳,等.不同性激素结合球蛋白水平对多囊卵巢综合征患者的影响[J].实用医学杂志,2016,32(12):1969-1971.
[6] 何 均,熊万宇,张昌军,等.性激素结合球蛋白对多囊卵巢综合征患者行IVF-ET促排卵效果及妊娠结局的预测[J].大连医科大学学报,2020,42(2):122-127.
[7] 赵磐琳,童 英,庞春元.不同促排卵方案对多囊卵巢综合征患者IVF-ET疗效的影响[J].中国计划生育学杂志,2017,25(2):97-100.
[8] Rotterdam ESHRE/ASRM-Sponsored PCOS consensus workshop group.Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome(PCOS)[J].Hum Reprod,2004,19(1):41-47.
[9] 袁莹莹,赵君利.多囊卵巢综合征流行病学特点[J].中国实用妇科与产科杂志,2019,35(3):9-12.
[10] 施 茵,虞莉青.多囊卵巢综合征与肥胖的关系及其中医治疗[J].针灸临床杂志,2010,26(2):61-65.
[11] 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.
[12] 黄翠玉,苏念军,叶荣琛,等.育龄期多囊卵巢综合征患者体质指数与血脂异常的关系:一项横断面研究[J].广东医学,2020,41(2):123-129.
[13] 刘彩娜,李佳佳,李林林,等.温针灸督脉联合克罗米芬治疗肾虚血瘀型多囊卵巢综合征不孕临床研究[J].陕西中医,2019,40(6):803-805.
[14] 周晓燕,汤美玲,马 娟,等.多囊卵巢综合征患者体外受精-胚胎移植妊娠结局的影响因素及预测[J].中国妇产科临床杂志,2020,21(4):370-373.
[15] 王力杰,姚 锐.短效避孕药联合GnRH-a对多囊卵巢综合征患者性激素及血脂水平的影响[J].现代实用医学,2018,30(11):1499-1501.
[16] 闫 雪,石玉华,盛 燕,等.多囊卵巢综合征患者体外受精-胚胎移植后的妊娠结局[J].中华妇产科杂志,2011,46(12):923-927.
[17] 沈涌海,邱 媛,施新颜,等.抗缪勒管激素联合硫酸脱氢表雄酮与性激素结合球蛋白检测对多囊卵巢综合征的相关性研究[J].中国卫生检验杂志,2018,28(4):447-448,452.
[18] 何 均,熊万宇,张昌军,等.性激素结合球蛋白对多囊卵巢综合征患者行IVF-ET促排卵效果及妊娠结局的预测[J].大连医科大学学报,2020,42(2):122-127.
[19] 李 琼.多囊卵巢综合征患者血清性激素结合球蛋白、瘦素及胰岛素抵抗对妊娠结局的影响[J].中国现代药物应用,2018,12(15):63-64.
[20] 聂春梅,李 燕.PCOS患者不良妊娠结局的相关因素分析[J].标记免疫分析与临床,2018,25(5):695-698.
[21] 李 江,王 刚.性激素结合球蛋白在多囊卵巢综合征患者中的变化及与其他指标的关系[J].天津医科大学学报,2016,22(4):325-327.

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备注/Memo

备注/Memo:
基金项目:西安市科技计划项目(J201901014); 西安市人民医院(西安市第四医院)科研孵化基金资助项目(BS-1)
更新日期/Last Update: 2021-04-06