血液氨基酸浓度与IVF-ET周期妊娠结局的相关性分析

Association of blood amino acid concentration with clinical pregnancy outcome

目的探讨血液各种氨基酸代谢物水平与不孕症患者IVF-ET助孕临床妊娠结局的相关性。方法选取2020年4月至2020年8月于中国医科大学附属盛京医院生殖医学中心行IVF-ET治疗的100例不孕症患者为研究对象,在胚胎移植后验孕日(第11~15天)留取外周静脉血,采用高效液相色谱法检测血液中18种氨基酸含量,根据是否获得临床妊娠分为妊娠组和未妊娠组,分析血液中氨基酸浓度与胚胎移植后妊娠结局的关系,并将与妊娠结局相关的氨基酸按浓度高低进行分组分析。结果临床妊娠者63例(63%),未妊娠者37例(37%)。妊娠组患者血液瓜氨酸的浓度[14.92(12.87,16.84)μmol/L]显著低于未妊娠组[16.71(14.50,19.44)μmol/L](P<0.05),妊娠组患者血液丝氨酸和谷氨酰胺的浓度[分别为178.02(157.00,194.87)μmol/L、11.99(9.99,13.75)μmol/L]显著高于未妊娠组[分别为162.76(139.43,187.86)μmol/L、10.99(9.46,12.80)μmol/L](P<0.05)。多因素Logistic回归分析表明瓜氨酸的浓度与妊娠呈负相关(P<0.05),丝氨酸的浓度与妊娠呈正相关(P<0.05)。与低浓度组相比,瓜氨酸高浓度组获得临床妊娠的概率降低71.9%;而丝氨酸中等浓度组获得临床妊娠的概率是低浓度组的2.65倍,高浓度组获得临床妊娠的概率是低浓度组的2.415倍。结论血液中瓜氨酸和丝氨酸的浓度与不孕症患者胚胎移植后的妊娠结局相关,瓜氨酸的浓度较低而丝氨酸的浓度较高时成功妊娠的概率较高。

Objective:To analyze the association between blood amino acid concentration and clinical pregnancy outcome in infertile women.Methods:One hundred infertile women who underwent IVF-ET treatment in our reproductive center from April 2020 to August 2020 were recruited.The samples of peripheral venous blood were collected on the day of HCG test after embryo transfer(11 th-15 th day),and the blood concentrations of 18 kinds of amino acids were detected by high performance liquid chromatography.All the patients were divided into pregnancy group and non-pregnant group according to the clinical pregnancy outcome.The correlation between the blood amino acid concentration and the pregnancy outcome after embryo transfer was analyzed.The amino acids related to pregnancy outcome were grouped according to the concentration and analyzed.Results:63 patients(63%)were clinically pregnant,and 37 patients(37%)were not pregnant.The blood concentration of citrulline in the pregnancy group[14.92(12.87,16.84)μmol/L]was significantly lower than that of the non-pregnant group[16.71(14.50,19.44)μmol/L](P<0.05),while the blood concentrations of serine[178.02(157.00,194.87)μmol/L vs.162.76(139.43,187.86)μmol/L]and glutamine[11.99(9.99,13.75)μmol/L vs.10.99(9.46,12.80)μmol/L]in the pregnancy group were significantly higher than those of the non-pregnant group(P<0.05).Multivariate regression analysis showed that the concentration of citrulline was negatively correlated with pregnancy outcome,while the concentration of serine was positively correlated with pregnancy outcome(P<0.05).The probability of clinical pregnancy in the high concentration of citrulline group decreased by 71.9%compared with the low concentration group.The probability of clinical pregnancy in the medium concentration of serine group was 2.65 times higher than that in the low concentration group,while the probability of clinical pregnancy in high concentration group was 2.415 times higher than that in low concentration group.Conclusions:The blood concentrations of citrulline and serine in infertile women are correlated with the pregnancy outcome after embryo transfer.When the concentration of citrulline is lower and serine is higher,the probability of successful pregnancy is higher.