抗苗勒管激素在子宫全切术后卵巢功能评价中的研究

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摘要目的研究抗苗勒管激素(AMH)在子宫全切术后卵巢功能变化监测中的意义,探讨子宫全切对卵巢功能的影响。方法选取因子宫肌瘤和子宫腺肌病行腹腔镜下子宫全切术并保留双侧附件的患者30例(全切组)和同期健康妇女30例(对照组),测定患者血清中的AMH、卵泡刺激素(FSH)、黄体生成素(LH)和雌二醇(E₂)水平和同时经阴道超声测量卵巢体积(OV)和卵巢间质动脉的阻力指数(RI),比较两组水平。结果全切组AMH、FSH、LH和E₂术前[(1.49±075)μg/L、(9.45±4.05)U/ L、(10.02±7.90)U/L、(55.55±14.68)ng/L]与术后1个月[(1.10±0.48)μg/L、(12.44±6.76)U/ L、(13.97±7.28)U/L、(44.45±13.81)ng/L]比较,全切组术后6个月AMH[(0.72±0.59)μg/L]与术前比较,全切组术后1个月AMH、FSH、LH和E₂与对照组1个月后[(1.47±0.75)μg/L、(9.56±3.61)U/L、(9.94±6.04)U/L、(51.53±14.60)ng/L]比较,全切组术后6个月AMH与对照组6个月[(1.46±0.83)μg/L]比较,全切组OV和RI术前[(6.63±2.37)cm、(0.59±0.20)]与术后1个月[(3.57±1.03)cm、(0.73±0.08)]比较,全切组OV和RI术后1个月与对照组1个月[(6.71±2.36)cm、(0.69±0.21)]比较,差异均有统计学意义。结论子宫全切术对卵巢功能近期有影响,AMH是监测卵巢功能变化更可靠、更敏感的指标。

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	尹红燕
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关键词 ：抗苗勒管激素, 卵巢功能, 子宫全切术, 卵泡刺激素, 黄体生成素, 雌二醇

Abstract：Objective To investigate the value of anti-Mullerian hormone (AMH) in evaluating ovarian function after total hysterectomy and the influence of total hysterectomy on ovarian function. Methods This study was conducted at the affiliated hospital of Weifang Medical College between February and November 2013. Thirty patients aged 40 and 50 years who underwent laparoscopic total hysterectomy for benign uterine diseases were enrolled into the case group and unaffected women in a similar age range constituted the control group. Serum levels of AMH, follicle-stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E₂) were assayed on the 7th to 10th day of menstruation before operation, at 1st month and 6th month of operation, respectively. At the same time, ovarian volume (OV) and ovarian stromal artery resistance index (RI) were measured through transvaginal ultrasound. Results In the case group, there were significant differences between pre-operation and at 1st month of operation in AMH [(1.49±075)μg/L vs. (1.10±0.48)μg/L], FSH [(9.45±4.05) U/L vs. (12.44±6.76) U/L], LH [(10.02±7.90) U/L vs. (13.97±7.28) U/L], E₂ [(55.55±14.68) ng/L vs. (44.45±13.81) ng/L], OV [(6.63±2.37) cm vs. (3.57±1.03) cm, and FI [(0.59±0.20) vs. (0.73±0.08)]. However, only AMH levels showed a statistical significance between pre-operation and at 6th month of operation [(0.72±0.59)μg/L]. In the control group, Levels of AMH, FSH, LH and E₂ levels, OV and RI at 1st and 6th month of operation were insignificantly difference compared with preoperative levels. There were significant differences at 1st month of operation between the case group and the control group in AMH [(1.47±0.75)μg/L, FSH (9.56±3.61) U/L, LH (9.94±6.04) U/L, E₂ (51.53±14.60) ng/L], OV [(6.71±2.36) cm, and RI (0.69±0.21)]. Only AMH level was significant different between case group and control group [(1.46±0.83)μg/L] at 6th month of operation. Conclusion It appears that total hysterectomy causes more or less loss of ovarian reserve function. AMH was a more reliable and sensitive index for evaluating ovarian function.

Key words： Anti-Mullerian hormone Ovarian function Hysterectomy Follicle-stimulating hormone Luteinizing hormone Estradiol

收稿日期: 2013-12-17

通讯作者: 吕秀萍 (xiuping927@163.com)

引用本文:

尹红燕, 刘玉珍, 吕秀萍, 张鹏, 孙小云. 抗苗勒管激素在子宫全切术后卵巢功能评价中的研究[J]. 中国生育健康杂志, 2014, 25(3): 223-225.
YIN Hongyan, LIU Yuzhen, LV Xiuping, ZHANG Peng, SUN Xiaoyun. The role of anti-Mullerian hormone on the evaluation of ovarian function after total hysterectomy. Chinese Journal of Reproductive Health, 2014, 25(3): 223-225.

链接本文:

http://cjrh.bjmu.edu.cn/CN/ 或 http://cjrh.bjmu.edu.cn/CN/Y2014/V25/I3/223

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