体外受精/卵胞质内单精子显微注射-胚胎移植技术出生的学龄期儿童内分泌状况的随访研究

A follow-up study of endocrine status in Chinese school-age children conceived by in vitro fertilization/intracytoplasmic sperm injection

目的：探讨通过体外受精／卵胞质内单精子显微注射．胚胎移植（IVF／ICSI—ET）技术出生的学龄期儿童内分泌状况是否与同年龄段自然受孕出生儿童存在差异。方法：选择通过IVF／ICSI—ET出生的6—11岁学龄期儿童（IVF／ICSI组）87例，检测其代谢及内分泌情况。并随机抽取同年龄段自然受孕出生儿童（NC组）74例作为对照。结果：IVF／ICSI组平均血红蛋白浓度（MCHC）（334．59±10．17g／L vs 330．74±13．58g／L）、血糖水平（4．57±0．33mmol／L vs 4．45±0．27mmol／L）均高于NC组，差异有统计学意义（P〈0．05）。红细胞数、白细胞数、血小板数、平均红细胞体积（MCV）、红细胞平均血红蛋白量（MCH）、三碘甲状腺原氨酸（T3）、甲状腺素（T4）、促甲状腺素（TSH）、空腹胰岛素（0hINS）及空腹生长激素（OhGH）组间差异无统计学意义（P〉0．05）。对影响MCHC的因素进行多重线性回归，是否为双胎、儿童身高对MCHC有影响：对影响血糖的因素进行多重线性回归，结果是否为试管婴儿、儿童性别、身高对血糖有影响。结论：IVF／ICSI-ET出生儿童内分泌状况与自然妊娠出生儿童无明显差异，空腹血糖（0h GLU）水平高于自然妊娠出生儿童，但均在正常范围内。

Objective： To discuss whether there is a difference in endocrine status between the Chinese school-age children conceived by in vitro fertilization/intracytoplasmic sperm injection （IVF/ICSI） technology and naturally conceived children. Methods： IVF/ICSI born children aged 6-11 years （n=87） were selected as IVF/ICSI group, while naturally conceived children at the same age （n=74） were randomly collected as normal control （NC） group. The endocrine status between the two groups was compared. Results： Twins proportion was higher in IVF/ ICSI group, and birth weight, body length of birth, gestational age were lower in IVF/ICSI group than in NC group （P〈0.05）. Red blood hemoglobin concentration （MCHC） level and glucose level in IVF/ICSI group were statistically significantly higher than those in the control （334.59±10.17 g/L vs 330.74 ±13.58 g/L, 4.57±0.33 mmol/L vs 4.45±0.27 mmol/L）. The factors affecting MCHC were analyzed using multiple linear regression, twin status and height were statistically significant. Similarly, the factors affecting blood sugar were also analyzed, test-tube baby, gender, and height were statistically significant. Conclusion： Children born by IVF/ICSI have higher fasting blood glucose levels than the natural pregnancy children, but all in the normal range.