抑制素B和窦卵泡计数评估卵巢储备功能的临床意义

The clinical significance of inhibin B and antral follicle count to evaluate ovarian reserve function

目的探讨血清抑制素B(INHB),窦卵泡计数(AFC),基础性激素水平及年龄与卵巢储备功能的关系及其预测价值。方法将卵巢功能不同的患者117例作为研究对象,分别为正常组43例,卵巢功能减退组(DOR)39例,卵巢早衰(POF)组35例。于月经周期的第3天检测3组患者的基础性激素水平[卵泡雌激素(FSH),黄体生成素(LH),雌二醇(E_2),孕酮(P),睾酮(T),泌乳素(PRL)及抑制素B(INHB),阴道B超下计算直径3~10 mm的AFC,并做相关性分析。结果 INHB水平及AFC在正常组最高,在POF组最低;INHB,AFC在3组间比较,差异有统计学意义(P<0.05),INHB和AFC与E_2,T呈正相关(P<0.05),与FSH,LH呈负相关(P<0.05),INHB和AFC呈正相关(P<0.05)。结论血清INHB与AFC与卵巢储备功能密切相关,结合基础内分泌指标能更准确地评估卵巢储备功能。

Objective To explore the ability to predict ovarian reserve function by INHB level,antral follicle count（AFC）,basal hormone level and female age.Methods One hundred and seventeen women with different ovarian reserve were recruited in the study and divided into three groups as follow：43 with normal ovarian reserve,39 with decreased ovarian reserve and 35 with premature ovarian failure（POF）.On the day3 of a spontaneous cycle,the basal hormone（FSH,LH,E2,P,T,PRL）and INHB levels were measured, the diameter 3-10 mm AFC number were determined by tansvaginal Doppler, and the correlation with INHB and AFC was analyzed.Results The AFC and INHB levels were both highest in normal group and lowest in POF group,the differences were statistically significant between 3 groups（P〈0.05）;AFC and INHB levels were both positively associated with E2,T（P〈0.05）,while both were negatively correlated with FSH,LH（P〈0.05）;INHB was positively associated with AFC（P〈0.05）.Conclusion Serum INHB level and AFC were correlated with ovarian reserve,showing that the combination of INHB and AFC with basal hormone may be a better predictor to ovarian reserve.