不孕症84例抑制素B检测的临床研究

Clinical analysis on detection of inhibin B in 84 cases with infertility

目的:检测84例不孕症患者月经第3天血清中抑制素B(INHB)、E2、FSH等,根据治疗效果了解上述激素在反映卵巢储备方面的价值,并探讨上述激素之间作用,为临床治疗不孕症提供理论依据。方法:FSH、E2采用化学发光法检测,INHB采用ELISA法检测。结果:①按INHB(45 pg/m l)分组,周期卵泡数、妊娠率等明显低于对照组(P<0.01),治疗剂量及时间反之(P<0.05)。按FSH(10m IU/m l)分组,周期卵泡数、妊娠率明显低于对照组(P<0.01),而治疗剂量、时间等则反之(P<0.05)。②按E2(80 pg/m l)分组,周期卵泡数、妊娠率明显高于对照组(P<0.05),而治疗剂量及时间等低于对照组(P<0.05)。③INHB与E2呈正相关,与FSH呈负相关;且卵巢储备降低的妇女INHB可能先于FSH增高、E2降低。结论:①INHB可作为反映卵巢储备的一个指标,卵巢功能下降时,其分泌可能首先减少,先于FSH、E2等指标变化,可能在反映卵巢储备方面优于FSH、E2等,在临床尤其在不孕症患者治疗过程中有一定指导意义。②INHB低于45 pg/m l者,卵巢储备差,建议此类患者治疗上应加大剂量促排卵等治疗。③INHB与传统上反映卵巢储备功能的指标如E2、FSH有相关性,如果将几项指标结合起来综合分析,更能正确反映女性卵巢储备功能。

Objective： To detect the levels of inhibin B, estrogen and follicle - stimulating hormone （FSH） in serum in 84 cases with infertility on the third day in menstrual cycle, understand the value of above - mentioned hormones in the response of ovarian reserve function, explore the relationship between the three of them, provide a scientific basis for infertility treatment. Methods ： The levels of estrogen and FSH were detected by chemiluminescence, while the level of inhibin B was detected by ELISA method. Results ： ①Dividing the cases into two groups according to the level of inhibin B （45 pg/ml）, the cycle follice amount and pregnancy rate in above 45 pg/ml group were lower than those in below 45 pg/ml group （ P 〈 0. 01 ） ; the therapeutic dose and time reversed （ P 〈 0. 05 ） . Dividing the cases into two groups according to the level of FSH （ 10 mIU/ml） , cycle follice amount and pregnancy rate in above 10 mIU/ml group were lower than those in below 10 mIU/ml group （ P 〈 0. 01 ） ; the therapeutic dose and time reversed （ P 〈 0. 05 ） . ②Dividing the cases into two groups according to the level of estrogen （80 pg/ml）, the cycle follice amount and pregnancy rate in above 80 pg/ml group were higher than those in below 80 pg/ml group （ P 〈 0. 05 ）, ; the therapeutic dose and tinle reversed （ P 〈 0. 05 ） .③There was positive correlation between inhibin B and estrogen, while there was negative correlation between inhibin B and FSH; the level of inhibin B of cases with low ovarian reserve function changed early than the increase of FSH and the decrease of estrogen. Conclusion ：①Inhibin B may be a marker of ovarian reserve function, which decreases with the degeneration of ovarian reserve function, the changes occurs early than FSH and estrogen, which plays a role in the treatment of infertility. ②The cases with inhibin B below 45 pg/ml have poor ovarian reserve function, superovulation treatment maybe effective.③Inhibin B is related to traditional markers （ FSH, estrogen）, combined application of three markers can reflect the ovarian reserve function correctly.