血清AMH水平在育龄期女性APS患者卵巢储备功能评价中的价值

Role of serum anti-Müllerian hormone levels in the evaluation of ovarian reserve in females with antiphospholipid syndrome of childbearing age

目的探讨血清抗缪勒氏管激素(AMH)和抑制素B(INHB)水平在育龄期女性抗磷脂综合征(APS)患者卵巢储备功能评价中的价值。方法选取女性APS患者86例[APS组,其中原发性抗磷脂综合征(PAPS)患者32例(PAPS组)、继发性抗磷脂综合征(SAPS)患者54例(SAPS组)]、除APS外的自身免疫性疾病女性患者52例(疾病对照组)、体检健康的育龄期女性50名(正常对照组)。检测所有对象月经周期第2~5天的血清AMH、INHB、黄体生成素(LH)、卵泡刺激素(FSH)和雌二醇(E2)水平,同时进行窦卵泡计数(AFC)。采用Pearson相关分析评估各项指标之间的相关性。结果APS组和疾病对照组的AMH、INHB、E2和AFC显著低于正常对照组(P<0.01);SAPS组的AMH显著低于PAPS组(P<0.05);APS组和疾病对照组中AMH<0.9 ng/mL者所占比例和AMH<0.5 ng/mL者所占比例均高于正常对照组(P<0.01),而APS组与疾病对照组之间差异均无统计学意义(P>0.05)。APS组AMH与INHB、AFC均呈正相关(r值分别为0.85、0.74,P<0.01)。结论血清AMH在育龄期女性APS患者卵巢储备功能评价中有重要价值。

Objective To investigate the roles of serum anti-Müllerian hormone(AMH)and inhibin B(INHB)levels in the evaluation of ovarian reserve in females with antiphospholipid syndrome(APS)of childbearing age.Methods Totally,86 female patients with APS(APS group),among whom 32 were primary antiphospholipid syndrome(PAPS)(PAPS group),and 54 are secondary antiphospolipid syndrome(SAPS)(SAPS group),were enrolled.A total of 52 female patients suffered from autoimmune diseases were enrolled as disease control group,and 50 healthy childbearing females were enrolled as healthy control group.All blood samples were collected within 2-5 d of a new menstrual cycle,which were determined for serum AMH,INHB,luteinizing hormone(LH),follicle stimulating hormone(FSH)and estradiol(E2)levels,and antral follicle count(AFC)was conducted simultaneously by transvaginal sonography.The correlations were evaluated by Pearson correlation analysis.Results The levels of AMH,INHB,E2 and AFC in APS group and disease control group were lower than those in healthy control group(P<0.01).AMH in SAPS group had lower results than that in PAPS group(P<0.05).The ratio of AMH<0.9 ng/mL and the ratio of AMH<0.5 ng/mL in APS group and disease control group were higher than those in healthy control group(P<0.01),but there was no statistical significance between APS group and disease control group(P>0.05).In APS group,AMH was positively correlated with INHB and AFC(r values were 0.85 and 0.74,P<0.01).Conclusions Serum AMH plays a role in the evaluation of ovarian reserve in female APS patients of childbearing age.