摘要
目的:探讨血清抗苗勒管激素(AMH)水平与子宫内膜异位症患者术后自然妊娠的关系。方法:收集本院2014年1月-2018年1月经腹腔镜手术治疗子宫内膜异位症患者375例,术前7d与术后1~3个月测定血清AMH、糖类抗原CA125水平,比较不同囊腔类型、单双侧及病理类型患者水平差异;随访12个月分析自然妊娠,采用logistics回归分析患者术后自然妊娠的影响因素。结果:术后AMH、CA125水平在囊腔为多房与单房,内膜异位为双侧与单侧,内膜类型为腹膜、卵巢、深部浸润型存在差异(P<0.05)。随访12个月中,51.7%自然妊娠,囊腔为单房孕妇的妊娠率(29.1%)高于多房(21.9%),单侧妊娠率(30.1%)高于双侧(20.8%),卵巢型妊娠率(20.5%)高于腹膜型(17.1%)深部浸润型(13.3%)(均P<0.05);术后妊娠组血清AMH水平高于未妊娠组,CA125水平低于未妊娠组(P<0.05);logistics回归分析,影响患者术后自然妊娠的因素为血清AMH水平、临床病理类型(P<0.05)。结论:血清AMH水平可对子宫内膜异位患者术后自然妊娠有影响,且异位内膜的类型对术后自然妊娠有影响,临床应加以重视。
Objective:To investigate the relationship between serum anti-mullerian hormone(AMH)level and the postoperative natural pregnancy situation of women with endometriosis.Methods:A total of 375 women with endometriosis treated by laparoscopic surgery from January 2014 to January 2018 were enrolled in this study.Serum AMH and carbohydrate antigen(CA)125 levels of all women 7 days before surgery and 1 to 3 months after surgery were detected and were compared between women with multiple rooms(in group A1)and single room(in group A2)of endometriosis different types,or between women with unilateral(in group B1)and bilateral(in group B2)of endometriosis,and among women with peritoneum endometriosis(in group C1),ovary endometriosis(in group C2),and deep infiltration endometriosis(in group C3).The natural pregnancy rate of women after followed up for 12 months was analyzed.Logistic regression was used to analyze the influencing factors of postoperative natural pregnancy rate of women with endometriosis.Results:The postoperative levels of AMH and CA125 of women had statistically significant different between group A1 and A2,between group B1 and B2,and among group C1,C2 and C2(P<0.05).Followed up for 12 months,the natural pregnancy rate of all women was 51.7%,that(29.1%)of women in group A2 was significant higher than that(21.9%)of women in group A1,that(30.1%)of women in group B1 was significant higher than that(20.8%)of women in group B2,that(20.5%)of women in group C2 was significant higher than that(17.1%)of women in group C1 and that(13.3%)of women in group C3(all P<0.05).The postoperative AMH level of women with pregnancy was significant higher than that of women without pregnancy,but the postoperative CA125 level of women with pregnancy was significant lower(P<0.05).Logistic regression analysis showed that serum AMH level and clinical pathological type of endometriosis were the factors affecting the postoperative natural pregnancy rate(P<0.05).Conclusion:Serum AMH level can affect the postoperative natural pregnancy rate,and the pathological type of endometriosis is relevant to the postoperative natural pregnancy rate,so both of them should be paid attention to in clinical practice.
作者
邰莹
任彦洁
王建
TAI Ying;REN Yanjie;WANG Jian(The First Affiliated Hospital of Air Force Military Medical University, Xi 'an, Shaanxi Province, 710032)
出处
《中国计划生育学杂志》
2020年第6期896-900,共5页
Chinese Journal of Family Planning
基金
国家自然科学基金委(81172458)。
