血清抗缪勒管激素联合生殖激素在卵巢早衰中的临床意义

Clinical significance of serum anti-Mullerian hormone combined with reproductive hormones in premature ovarian failure

目的探讨血清抗缪勒管激素(AMH)、卵泡生成激素(FSH)、促黄体生成素(LH)和雌二醇(E2)在卵巢早衰患者中的水平及其临床意义。方法选取2021年6月至2023年6月郑州大学第一附属医院收治的46例卵巢早衰患者作为研究对象,选择同期来我院体检的健康者作为对照。检测并比较AMH、FSH、LH和E2水平。采用维生素E和克龄蒙治疗4个周期后,分析治疗前后患者AMH、FSH、LH和E2水平,并分析AMH、FSH、LH和E2水平与改良Kupperman评分的关系。组间比较采用t检验。结果健康者血清抗缪勒管激素和雌二醇水平[(3.61±0.51)ng/ml、(73.20±11.02)pg/ml]明显高于卵巢早衰患者[(0.10±0.02)ng/ml、(25.27±4.98)pg/ml],差异有统计学意义(t=19.340、19.410,P<0.05)。健康者血清卵泡生成激素和促黄体生成素水平[(4.54±2.12)、(5.77±1.04)IU/L]明显低于卵巢早衰患者[(30.02±5.671)、(31.08±7.27)IU/L],差异有统计学意义(t=24.820、16.880,P<0.05)。治疗后患者血清抗缪勒管激素和雌二醇水平[(0.22±0.03)ng/ml、(39.61±6.01)pg/ml]明显高于治疗前卵巢早衰患者[(0.10±0.02)ng/ml、(25.27±4.98)pg/ml],差异有统计学意义(t=10.920、9.000,P<0.05)。治疗后患者血清卵泡生成激素和促黄体生成素水平[(21.56±5.31)、(12.99±3.04)IU/L]明显低于卵巢早衰患者治疗前[(30.02±5.67)、(31.08±7.27)IU/L],差异有统计学意义(t=18.410、10.620,P<0.05)。治疗后患者Kupperman评分[(6.08±1.41)分]明显低于治疗前患者Kupperman评分[(14.46±1.56)分],差异有统计学意义(t=19.500,P<0.05)。卵巢早衰患者的血清卵泡生成激素和促黄体生成素水平与改良Kupperman评分呈正相关(r=0.614、0.419、0.558,P<0.05)。而卵巢早衰患者的血清抗缪勒管激素和雌二醇水平与改良Kupperman评分呈负相关关系(r=-0.547、-0.459,P<0.05)。结论卵巢早衰患者血清FSH和LH水平明显增加,而AMH和E2水平显著下降,并与患者改良Kupperman评分密切相关。

Objective To investigate the levels and clinical significance of serum anti-Mullerian hormone(AMH),follicle stimulating hormone(FSH),luteinizing hormone(LH),and estradiol(E2)in patients with premature ovarian failure.Methods 46 patients with premature ovarian failure in Zhengzhou university first affiliated hospital from June 2021 to June 2023 were selected,and healthy individuals who came to our hospital for physical examination during the same period were selected as controls.After 4 cycles of treatment with vitamin E and clenbuterol,the serum levels of AMH,AMH,FSH,LH,and E2 in patients before and after treatment were analyzed,and the relationship between AMH,FSH,LH,and E2 levels and the modified Kupperman score was analyzed.The comparison of inter group measurement data adopts t-test.Results The serum levels of AMH and E2 in healthy individuals[(3.61±0.51)ng/ml,(73.20±11.02)pg/ml]were significantly higher than those in patients with premature ovarian failure[(0.10±0.02)ng/ml,(25.27±4.98)pg/ml,t=19.340,19.410,P<0.05].The serum levels of FSH and LH in healthy individuals[(4.54±2.12),(5.77±1.04)IU/L]were significantly lower than those in patients with premature ovarian failure[(30.02±5.671),(31.08±7.27)IU/L,t=24.820,16.880,P<0.05].After treatment,the serum levels of AMH and E2 in patients[(0.22±0.03)ng/ml,(39.61±6.01)pg/ml]were significantly higher than those in patients with premature ovarian failure before treatment[(0.10±0.02)ng/ml,(25.27±4.98)pg/ml,t=10.920,9.000,P<0.05].After treatment,the serum levels of FSH and LH in patients[(21.56±5.31),(12.9±3.04)IU/L]were significantly lower than those before treatment[(30.02±5.67),(31.08±7.27)IU/L,t=18.410,10.620,P<0.05].After treatment,the Kupperman score of patients(6.08±1.41)was significantly lower than that of patients before treatment(14.46±1.56,t=19.500,P<0.05).The serum levels of FSH and LH in patients with premature ovarian failure were significantly correlated with the modified Kupperman score(r=0.547,0.614,0.419,0.558,P<0.05).The serum AMH and E2 levels in patients with premature ovarian failure were significantly negatively correlated with the modified Kupperman score(r=-0.459,P<0.05).Conclusion Serum FSH and LH levels significantly increase in patients with premature ovarian failure,while AMH and E2 levels significantly decrease,and are closely related to the patient’s improved Kupperman score.