抗苗勒管激素对卵泡发育的影响

临床军医杂志(Clin J Med Offic )2009年2月第37卷第1期

抗苗勒管激素对卵泡发育的影响

赵海波,宋　晖,于月成　(解放军第四军医大学西京医院　妇产科,陕西　西　安　710032)

摘要:目的　探讨血清抗苗勒管激素(AMH )水平对促排卵效果的影响。方法　排卵障碍患者70例,其中多囊卵巢综合征(PCOS )40例

(PCOS 组),非PCOS 者30例(非PCOS 组),尿促性素(h MG )促排卵。月经周期2～3d (基础日)及注射绒促性素(hCG )日抽取空腹静脉

血测AMH 、雌激素(E )及雄激素(T )水平,分析血清AMH 水平与促排卵效果的关系。20例健康妇女做正常对照。结果　PCOS 组血清基础AMH 为(48.2±18.3)pmol/L,明显高于非PCOS 组及对照组(P <0.01),后两组间的基础AMH 差异无统计学意义。非PCOS 组基础

AMH 水平低者,促排卵药用量大,获得的成熟卵泡少;而PCOS 组基础AMH 水平低者促排卵药用量小,获得的成熟卵泡多。结论　血清基

础AMH 水平对不同排卵障碍患者的影响是不同的,PCOS 患者血清基础AMH 水平低,促排卵效果好,而非PCOS 患者血清基础AMH 水平低,预示促排卵效果差。

关键词:抗苗勒管激素;排卵障碍;多囊卵巢综合征;促排卵

中图分类号:R 711175 文献标志码:A 文章编号:167123826(2009)0120066203

I nfluence of Serum An ti 2m üller i a n Horm one Ba s a l L evels on O vula tion I nduc 2ti on

Zhao Hai 2bo,Song Hui,Yu Yue 2cheng (Xijing Hos p ital of Fourth M ilitary M edical University,Xi’an 710032,China )Abstract :O bjecti ve To observe the influence of serum anti 2m üllerian hor mone (AMH )basal levels on ovulati on inducti on .M ethods Seventy patients of anovulat ory patients were treated with human menopausal gonadotr op in (h M G )f or ovulati on induc 2ti on .Among them ,40suffered fr om polycystic ovary syndr ome (PCOS )(PCOS gr oup ),and the other 30suffered fr om non 2PCOS (non 2PCOS gr oup ).Fasting serum levels of AMH ,estradi ol (E ),and test oster one (T )were measured on the second (or third )day of menstrual cycles (basal day )and hCG 2injecti on day,respectively .The influence of serum AMH basal levels on ovulati on in 2ducti on were evaluated .T wenty age 2matched healthy women were chosen as contr ols .Results The serum basal AMH level in the PCOS gr oup was 48.2±18.3pmol/L ,significantly higher than that in the non 2PCOS gr oup and that in the contr ols (P <0.01),and the difference bet w een the later t w o gr oup s was not significant .I n the non 2PCOS gr oup,the l ower the basalAMH levelwas,the more the h M G was needed,and the fewer the mature follicles were obtained .On the contrary in the PCOS gr oup,if the basal AMH level was l ower,less h M G was needed and more mature f ollicles were obtained .Conclusi on The influence of serum AMH basal levels on ovulati on inducti on is different,which depends on the anovulat ory causes .

Key words:anti 2m üllerian hor mone;polycystic ovary syndr ome;anovulati on;ovulati on inducti on

排卵障碍是女性不孕的主要原因之一,治疗方法是促排卵。临床上观察到,排卵障碍患者对促排卵药物反应不一,常有部分患者对促排卵反应很差。抗苗勒管激素

(AMH )是转化生长因子β超家族成员之一,由560个氨基

酸残基组成的糖蛋白,相对分子质量140000,具有调节细胞发育及分化,并使雄性胚胎苗勒管退化的作用[1]。近年研究发现,AMH 在调控卵泡生长和发育中具有一定作用[2]。本研究对70例排卵障碍患者进行了血清AMH 水

平检测,以探讨基础AMH 对促排卵效果的影响。

1　资料与方法

1.1　研究对象　2007年11月—2008年6月,选择第四

军医大学西京医院妇产科不孕症专科门诊排卵障碍患者

70例,年龄23～36岁,平均(32.6±3.1)岁。排卵障碍患

者的选择标准:(1)连续3个周期阴道超声卵泡监测无卵泡发育及排卵;(2)排除输卵管梗阻、免疫性不孕及男方精液异常;(3)排除其他内分泌疾病及近3个月内未用激素类

收稿日期:2008209211

作者简介:赵海波(19582),男,黑龙江人,副教授,医学硕士。

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