腹腔镜下卵巢良性囊肿剥除术对患者血清抗苗勒管激素水平的影响被引量：9

Effect of Laparoscopic Cystectomy on Serum Anti-Mullerian Hormone Level in Patients with Diverse Benign Ovarian Cysts

下载PDF

导出

摘要目的：通过检测手术前后卵巢良性囊肿患者血清抗苗勒管激素（AMH）水平的变化，探讨腹腔镜下囊肿剔除术对卵巢储备功能的影响。方法选取2014年4月—2015年4月因单侧良性卵巢囊肿行腹腔镜下卵巢囊肿剔除术的46例患者，根据术后病理将患者分为巧囊组（n=23）、非巧囊组（n=23），术中创面止血采用双极电凝法。同时选取25例正常育龄妇女为对照组。于术前2 d及术后3 d、6个月检测AMH水平。结果术前非巧囊组与对照组血清AMH水平比较，差异无统计学意义（P﹥0.05），而巧囊组AMH水平明显低于非巧囊组及对照组（P﹤0.05）；术后3 d两组AMH水平均较术前明显下降，其中巧囊组下降更为明显；术后6个月非巧囊组和巧囊组AMH水平与术前相比差异均无统计学意义。结论腹腔镜下卵巢良性囊肿剥除术对卵巢储备功能会产生不同程度的近期损害，与卵巢囊肿病理类型有关，对内异囊肿患者影响尤为明显。 Objective To evaluate the effect of laparoscopic cystectomy on ovarian reserve in patients with diverse benign ovarian cysts by investigating the serum anti-Mullerian hormone （AMH） level before and after operation.Methods A total of 46 patients who underwent laparoscopic cystectomy due to unilateral ovarian cyst from April 2014 to April 2015 were recruited in this retrospective analysis. All patients were divided into endometrioma group and nonendometrioma group by pathological types. The surgery hemostatic method was bipolar electrocoagulation. 25 females in the same age were selected as the normal control group （NCG）. Serum AMH levels were measured before operation and at 3 days, and 6 months follow-up visit afterwards.Results There were no signiifcant differences between nonendometrioma group and NCG in terms of serum AMH levels before operation. Serum AMH level was found to be lower in endometrioma group than that in nonendometrioma group and NCG before operation. Serum AMH level was found to be lower in both nonendometrioma group and endometrioma group after operation, AMH more markedly declined in endometrioma group at postoperative 3 days. At 6 months postoperatively, AMH levels were found to be similar between two groups.Conclusion Laparoscopic cystectomy could impair the ovarian reserve to some extent in patients with ovarian cysts in the immediate future and the effects could be related with the pathological patterns. The influence seems to be more obvious in patients with endometrioma.

作者奚晓雪杨晨戴建荣

机构地区苏州市立医院妇产科

出处《中国血液流变学杂志》 CAS 2015年第4期472-475,共4页 Chinese Journal of Hemorheology

关键词抗苗勒管激素卵巢储备卵巢囊肿腹腔镜卵巢囊肿剥除术 AMH ovarian reserve ovarian cysts laparoscopic cystectomy

分类号 R713.6 [医药卫生—妇产科学]

引文网络
相关文献

参考文献10

1Hansen KR, Hodnett GM, Knowlton N, et al. Correlationof ovarian reserve tests with histologically determinedprimordial follicle number[J]. Fertil Steril, 2011, 95(1):170-175.
2Oosterhuis GJ, Michgelsen HW, Vermes I. Laboratorymarkers of ovarian flinction[J]. Adv Clin Chem, 2000, 35:295-331.
3Weenen C, Laven JS, Von Bergh AR, et al. Anti-Mtillerianhormone expression pattern in the human ovary: potentialimplications for initial and cyclic follicle recruitment[J].Mol Hum Reprod, 2004, 10(2): 77-83.
4Fanchin R, Schonauer LM, Righini C, et al. Serum anti-Mullerian hormone dynamics during controlled ovarianhyperstimulation[J]. Hum Reprod, 2003, 18(2): 328-332.
5Seifer DB, Maclaughlin DT. Mullerian InhibitingSubstance is an ovarian growth factor of emerging clinicalsignificance[J]. Fertil Steril, 2007, 88(3): 539-546.
6Kini S, Li HW, Morrell D, et al. Anti-mullerianhormone and cumulative pregnancy outcome in in-vitrofertilization];J]. J Assist Reprod Genet, 2010, 27(8): 449-456.
7李凤翔.超声刀对腹腔镜卵巢囊肿剥除术后卵巢功能的影响[J].中国内镜杂志,2012,18(7):706-708. 被引量：14
8李大志,祝亚平.子宫内膜异位症对卵巢功能的影响[J].国际妇产科学杂志,2008,35(4):262-264. 被引量：10
9Muzii L, Bellati F, Palaia I, et al. Laparoscopic strippingof endometriomas: a randomized trial on different surgicaltechniques. Part I : clinical results[J]. Hum Reprod, 2005,20(7): 1981-1986.
10Chang HJ, Han SH, Lee JR, et al. Impact of laparoscopiccystectomy on ovarian reserve: serial changes of serumanti-Mullerian hormone levels[J]. Fertil Steril, 2010,94(1):343-349.

二级参考文献22

1[1]Siristatidis C,Nissotakis C,Chrelias C,et al.Immunological factors and their role in the genesis and development of endometriosis[J].J Obstet Gynaecol Res,2006,32(2):162-170.
2[2]Gupta S,Agarwal A,Agarwal R,et al.Impact of ovarian endometrioma on assisted reproduction outcomes[J].Reprod Biomed Online,2006,13(3):349-360.
3[3]Suzuki T,Izumi S,Matsubayashi H,et al.Impact of ovarian endometrioma on oocytes and pregnancy outcome in in vitro fertilization[J].Fertil Steril,2005,83(4):908-913.
4[4]Graciela K,Frederick S,Hugh T,et al.Endometriosis and tissue factor[J].Ann N Y Acad Sci,2008,1127(1):101-105.
5[5]Rrichter ON,Dorn C,R(o)sing B,et al.Tumor necrosis factor alpha secretion by peritoneal macrophages in patients with endometriesis[J].Arch Gynecol Obstet,2005,271 (2):143-147.
6[6]Morrison LJ,Marcinkiewicz JL.Tumor necrosis factor alpha enhances oocyte/follicle apoptosis in the neonatal rat ovary[J].Biol Reprod,2002,66(2):450-457.
7[7]Kalu E,Sumar N,Giannopoulos T,et al.Cytokine profiles in serum and peritoneal fluid from infertile women with and without endometriosis[J].J Obstet Gynaecol Res,2007,33(4):490-495.
8[8]Deura I,Harada T,Taniguchi F,et al.Reduction of estrogen production by interleukin-6 in a human granulosa tumor cell line may have implications for endometriosis-associated infertility[J].Fertil Steril,2005,83[Suppl 1]:1086-1092.
9[9]González-Ramos R,Donnez J,Defrère S,et al.Nuclear factor-kappa B is constitutively activated in peritoneal endometriosis[J].Mol Hum Reprod,2007,13(3):503-509.
10[10]Gilabert-Estellès J,Ram6n LA,Espa(n)a F,et al.Expression of angiogenic factors in endometriosis:relationship to fibrinolytic and metalloproteinase systems[J].Hum Reprod,2007,22(8):2120-2127.