围绝经期妇女血清抑制素B水平测定及临床意义

Detection and clinical analysis of serum inhibins B in perimenopausal women

目的：探讨围绝经期妇女血清抑制素B（InhibinsB）水平的变化、并分析其与围绝经期症状、月经状态的关系。方法：289例围绝经期妇女按照月经周期情况分为4组，研究组1共有106例，月经周期规律；研究组2共有84例，月经周期不规律，但最长周期不超过3个月；研究组3共有63例，月经周期不规律，月经周期在3～11个月之间；研究组4，绝经1年，共有36例。每位妇女均测定血清抑制素B、卵泡刺激素（follicle stimulating hormone，FSH）、雌激素（您）水平，及临床症状分析。结果：（1）InhibinsB水平研究组2与研究组1相比明显下降（P〈0．001），但与研究组3、研究组4相比没有变化（P〉0．05）；FSH水平研究组2与研究组1相比无变化（P〉0．05）；E2水平研究组2与研究组1相比无意义（P〉0．05）。②FSH、E2水平在正常范围内时，InhibimB〈50ng／L组临床症状发生率明显高于InhibinsB〉50ng／L组（P〈0．05）。结论：早期围绝经期妇女内分泌变化是抑制素B水平下降、雌激素水平可无变化。

Objective： To investigate the change of serum concentrations of inhibin B in perimenopausal women and to evaluate the relationship between inhibin B and climacteric symptoms and menstrual pattern. Methods： Two hundred eighty - nine pefimenopansal women were divided into 4 groups by menstrual pattern. 106 cases in groupl （had a regular menstrual cycle of 21 to 35 days） ; 84 cases in group 2 （had an irregular menstrual cycle between 2 and 3 months） ; 63 cases in group 3 （had an irregular menstrual cycle between 3 and 11 months） ; 36cases in group 4 （ no menses in the preceding 12 months）. Serum concentrations of inhibins B, estradiol （E2） and follicle stimulating hormone （FSH） were measured. Results： （1）The levels of inhibins B had significantly decreased in group 1 than that of group 2 （P 〈 0. 001 ）. The levels of inhibins B had not changes in group 2, 3 and 4 （P 〉 0. 05）. The levels of FSH and E2 had no changes in group 1 and 2 （ P 〉 0. 05）. （2）The prevalences and severity of climacteric symptoms （ such as hot flushes and vaginal dryness） were significantly higher （ P 〈 0. 05 ） in inhibins B less than 50 ng/L and FSH, E2 in normal range group than those in inhibins B more than 50 ng/ L and FSH, E2 in normal range group. Conclusion： The major significant endocrine event in perimenopansal women is a fall in the circulating levels of inhibin B without significant change in eestradiol.