卵巢巧克力囊肿对卵巢储备功能的影响分析

Impact of Endometriomas on Ovarian Reserve and Exploration of Related Factors

【目的】以代表卵巢储备功能的血清抗苗勒氏管激素(AMH)为指标评估卵巢巧克力囊肿对卵巢储备功能的影响,并探讨相关影响因素。【方法】收集2013年6月至2014年01月在我院行卵巢巧克力囊肿、卵巢其他良性包块剔除及因输卵管因素不孕行腹腔镜手术的患者共98例,其中巧囊组40例、卵巢其他良性包块对照组22例,输卵管性不孕对照组36例。收集患者术前肘静脉血检测血清AMH值,通过秩和检验来比较各组间血清AMH的差异,应用相关分析来探索影响血清AMH水平的因素。【结果】巧囊组术前血清AMH值(1.53±1.37)ng/mL较卵巢其他良性包块组的(2.20±1.23)ng/mL、不孕组的(2.82±1.74)ng/mL均低,而卵巢其他良性包块组与不孕对照组差异无统计学意义。巧囊组患者术前血清AMH值与年龄均呈负相关,相关系数r=-0.54;与BMI、囊肿总大小相关性均无统计学意义。巧囊组单双侧术前血清AMH值比较差异亦无统计学意义。【结论】卵巢巧克力囊肿病变可降低患者血清AMH水平,损害患者卵巢储备功能。巧克力囊肿大小、单双侧均非影响患者血清AMH值的因素,而年龄与血清AMH值呈负相关,是影响卵巢储备功能的一个负面因素。

[Objective] To evaluate the presence of endometriomas on ovarian reserve as assessed by serum anti-Müllerian hormone （AMH） through compared with other benign ovarian cysts and infertility.Also,the related factors were also analyzed.[Methods] From June 2013-January 2014,we prospectively accumulated 40 women with endometriomas,22 women with other benign ovarian cysts and 36 infertilities.Serum AMH level were determined preoperatively and compared.Also,correlation analyses were undertaken in order to identify determinants of related factors to ovarian reserve.[Results] Compared with controls at baseline,women with endometriomas （1.53 ± 1.37 ng/mL） had lower AMH levels while the difference between other benign ovarian cysts （2.20 ± 1.23 ng/mL） and infertilities （2.82 ± 1.74 ng/mL） was not significant.There was a negative correlation between serum AMH and age in endometrioma group,r =-0.54.BMI,cyst size,bilaterality was not correlated with serum AMH level.[Conclusion] The presence of endometriomas per se was associated with a decrease in serum AMH but not the other benign ovarian cysts.Bilaterality of the endometrioma cyst,endometrioma size was not correlated with serum AMH level.But AMH was negatively correlated with age.