血同型半胱氨酸水平与多囊卵巢综合征患者妊娠结局的关系

Correlation between serum homocysteine level and pregnancy outcome in patients with polycystic ovary syndrome

目的探讨血清同型半胱氨酸(Hcy)水平与多囊卵巢综合征(PCOS)患者妊娠结局的关系。方法回顾性分析547例PCOS患者的临床资料,以Hcy≥12μmol/L为切点将患者分为高Hcy组(Hcy≥12μmol/L, 179例)和低Hcy组(Hcy<12μmol/L, 368例)。比较两组患者一般资料[年龄、体质量指数(BMI)、抗苗勒管激素(AMH)、Hcy]及临床妊娠率和妊娠早期流产率。结果高Hcy组患者的Hcy为(15.69±2.79)μmol/L,显著高于低Hcy组的(8.73±2.01)μmol/L,差异具有统计学意义(P<0.05);两组患者的年龄、BMI、AMH水平比较差异均无统计学意义(P>0.05)。高Hcy组患者临床妊娠38例、妊娠率为21.23%,妊娠早期流产11例、流产率为28.95%;低Hcy组患者临床妊娠126例、妊娠率为34.24%,妊娠早期流产15例、流产率为11.90%。低Hcy组患者临床妊娠率高于高Hcy组,妊娠早期流产率低于高Hcy组,差异均有统计学意义(P<0.05)。结论高水平Hcy可导致PCOS患者临床妊娠率降低,妊娠早期流产率升高,临床上应予以更多关注并尽早干预和治疗。

Objective To discuss the correlation between serum homocysteine(Hcy) level and pregnancy outcome in patients with polycystic ovary syndrome(PCOS). Methods The clinical data of 547 patients with PCOS were retrospectively analyzed. The patients were divided into high-Hcy group(Hcy≥12 μmol/L, 179 cases) and low-Hcy group(Hcy<12 μmol/L, 368 cases) with Hcy≥12 μmol/L as the cut-off point. The clinical data [age, body mass index(BMI), anti-Müllerian hormone(AMH) and Hcy], clinical pregnancy rate and abortion rate in early pregnancy were compared between the two groups. Results Hcy of high-Hcy group was(15.69±2.79) μmol/L, which was significantly higher than that of low-Hcy group(8.73±2.01) μmol/L, and the difference was statistically significant(P<0.05). There was no statistically significant difference in age, BMI and AMH between the two groups(P>0.05). In the high-Hcy group, there were 38 cases of clinical pregnancy, with a pregnancy rate of 21.23%, 11 cases of miscarriage in early pregnancy, with an abortion rate of 28.95%. In the lowHcy group, there were 126 cases of clinical pregnancy, with a pregnancy rate of 34.24%, 15 cases of miscarriage in early pregnancy, with an abortion rate of 11.90%. The clinical pregnancy rate of high-Hcy group was higher than that of low-Hcy group, abortion rate in early pregnancy was lower than that of high-Hcy group, and the difference was statistically significant(P<0.05). Conclusion High levels of Hcy can lead to a decrease in the clinical pregnancy rate and an increase in early abortion in patients with PCOS. More attention should be paid to clinical intervention and treatment as soon as possible.