诱发排卵障碍PCOS患者皮质醇激素水平变化及意义

Changes of cortisol levels in PCOS patients with induced ovulation disorder and the significance

目的:研究诱发排卵障碍的多囊卵巢综合征(PCOS)患者血清皮质醇水平及临床意义。方法:应用排卵药物克罗米芬+人绒毛膜促性腺激素(CC/HCG)诱发PCOS患者(73例)进行排卵,在诱发排卵的月经周期中,根据是否排卵分为两组(排卵障碍组30例、排卵成功组43例),应用电化学发光法测定两组患者卵泡生长在不同时期及排卵时期的血清皮质醇激素水平,并进行统计学处理和分析。结果:卵泡生长5、10和15 mm时,两组皮质醇水平比较差异无统计学意义(P>0.05);卵泡生长20 mm时,排卵障碍组血清皮质醇水平低于排卵成功组(P<0.05)。排卵障碍组患者血清皮质醇激素水平与体重、甘油三脂、血糖呈负相关性(r=-0.806,P<0.05;r=-0.361,P<0.05;r=-0.336,P<0.05)。排卵成功组血清皮质醇水平与体重、甘油三脂、血糖呈负相关性(r=-0.169,P<0.05;r=-0.273,P<0.05;r=-184,P<0.05)。结论:排卵成功组患者卵泡成熟时期血清皮质醇激素水平较高,皮质醇激素水平低下在一定程度上影响正常排卵。

Objective： To study serum cortisol levels in polycystic ovary syndrome（ PCOS） patients with induced ovulation disorder and the clinical significance. Methods： Induced ovulation was performed among 73 patients with PCOS via clomiphene and human chorionic gonadotropin（ CC / HCG）,then the patients were divided into ovulation disorder group（ 30 patients） and successful ovulation group（ 43 patients）. Electrochemiluminescence was used to detect serum cortisol levels during different follicular development periods in the two groups,the data was analyzed statistically. Results： There was no statistically significant difference in serum cortisol level between the two groups when the diameters of follicles were 5,10 and 15 mm（ P〉0. 05）; serum cortisol level in ovulation disorder group was statistically significantly lower than that in successful ovulation group when the diameter of follicles was 20 mm（ P〈0. 05）. In ovulation disorder group,serum cortisol level was negatively correlated with body weight,triglyceride,and blood glucose（ r =- 0. 806,P〈0. 05; r =- 0. 361,P〈0. 05; r =- 0. 336,P〈0. 05）. In successful ovulation group,serum cortisol level was negatively correlated with body weight,triglyceride,and blood glucose（ r =- 0. 169,P〈0. 05; r =- 0. 273,P〈0. 05; r =- 184,P〈0. 05）. Conclusion： Serum cortisol levels in successful ovulation group are relatively high when follicles are mature,low cortisol level has impact on normal ovulation to a certain extent.