血清炎症指标检测在多囊卵巢综合征患者宫腔内人工授精中的应用价值

Application of serum inflammation index in intrauterine insemination of polycystic ovary syndrome

目的:探究多囊卵巢综合征(PCOS)人工授精患者血清C反应蛋白(CRP)、白细胞介素6(IL-6)、降钙素原(PCT)水平及其临床应用价值。方法:选择101例PCOS患者,设为研究组,选取同期因男方少弱精子症需要进行宫腔内人工授精的女性50例,设为对照组。采用酶联免疫吸附法(ELISA)检测两组受检者血清CRP、IL-6、PCT水平并进行对比,统计两组受检者的妊娠结局,血清CRP、IL-6、PCT水平与人工授精妊娠结局的相关性分析。采用受试者工作特征曲线(receiver operating characteristic curve,ROC)评估血清CRP、IL-6、PCT水平在预测PCOS人工授精妊娠结局的应用价值。结果:研究组患者的CRP、IL-6、PCT水平分别为(8.2±1.4)mg/L、(354.1±41.6)ug/ml、(69.4±6.9)ug/L,对照组患者的CRP、IL-6、PCT水平分别为(2.3±0.6)mg/L、(161.5±12.8)ug/ml、(41.0±4.5)ug/L,研究组均显著高于对照组,两组之间的差异具有统计学意义(P<0.05);研究组患者排卵率、临床妊娠率均低于对照组,其中排卵率两组比较差异具有统计学意义(P<0.05),研究组患者流产率和多胎率均高于对照组,但是差异无统计学意义(P>0.05)。相关性分析结果显示,血清CRP、IL-6、PCT与多囊卵巢综合征患者排卵率、临床妊娠率呈负相关(r值分别为-0.687,-0.561,-0.809;-0.863,-0.698,-0.807;P<0.05),与流产率以及早产率呈正相关(r值分别为0.613,0.563,0.442;0.569,0,576;0.543;P<0.05);临床妊娠的PCOS患者血清CRP、IL-6、PCT明显低于未妊娠组(P<0.05),血清CRP、IL-6、PCT在预测PCOS人工授精结局的ROC曲线下面积分别为0.869、0.823、0.715。结论:PCOS患者血清CRP、IL-6、PCT水平与PCOS人工授精妊娠结局具有明显的相关性,并且有可能成为预测人工授精妊娠结局的指标。

Objective： To investigate the levels of serum C-reactive protein（ CRP）,interleukin-6（ IL-6）and procalcitonin（ PCT） in patients with polycystic ovary syndrome（ PCOS）,and its clinical value. Methods： A total of 101 patients with PCOS were selected as the study group. 50 female patients received intrauterine insemination because of asthenospermia of their spouse in the same period were selected as the control group. The levels of serum CRP and IL-6 were measured by ELISA. The level of serum CRP,IL-6,PCT and the level of artificial insemination pregnancy were analyzed. The serum CRP,IL-6 and PCT were evaluated by ROC curve to predict the application value of PCOS artificial insemination outcome. Results： The levels of CRP,IL-6 and PCT in the study group were（ 8. 2 ± 1. 4） mg/L,（ 354. 1 ± 41. 6） ug/ml and（ 69. 4 ± 6. 9） ug/L respectively,while those in the control group were（ 2. 3 ± 0. 6） mg/L,（ 161. 5 ± 12. 8） ug/ml and（ 41. 0 ± 4. 5） ug/L respectively,with statistically significant difference between the two groups（ P〈0. 05）. The ovulation rate and clinical pregnancy rate of the study group were all lower than those in the control group,with statistically significant difference in ovulation rate between the two groups（ P〉0. 05）. The abortion rate and the high-order birth rate of the study group were higher than those of the control group,but the difference was not statistically significant（ P〈0. 05）. The correlation analysis showed that serum CRP,IL-6,PCT was negatively correlated with the ovulation rate and clinical pregnancy rate of patients（ R = 0. 613,0. 563,0. 442; 0. 569,0,576; 0. 543; P〈0. 05）. The levels of serum CRP and IL-1 in patients with PCOS were significantly higher than those in the control group（ P〈0. 05）. The area under the ROC curve of serum CRP,IL-6 and PCT was 0. 869,0. 823,0. 715 in the predicted PCOS artificial insemination outcome. Conclusions： The levels of serum CRP,IL-6 and PCT in PCOS patients are significantly correlated with the outcome of artificial insemination pregnancy,and may be an indicator predicting the outcome of artificial insemination.