INHB、AMH及IL-21水平与卵巢良性肿瘤患者卵巢储备功能的相关性分析

Correlation analysis of serum inhibin B(INHB),anti-mullerian hormone(AMH),and interleukin-21(IL-21)levels with ovarian reserve function in patients with benign ovarian tumor

目的分析血清抑制素B(Inhibin B,INHB)、抗苗勒管激素(Anti-mullerian hormone,AMH)及白细胞介素-21(Interleukin-21,IL-21)水平与卵巢良性肿瘤患者卵巢储备功能的相关性。方法收集2020年1月-2023年12月黑龙江中医药大学附属第二医院妇科收治的104例卵巢良性肿瘤患者为研究对象,根据患者术后3个月时窦卵泡计数(Antral gollicle count,AFC)分为卵巢储备低功能组(n=46)与正常组(n=58)。比较两组患者的一般资料,术前及术后3个月血清INHB、AMH及IL-21水平。采用多因素Logistic回归模型分析卵巢良性肿瘤患者卵巢储备功能的影响因素,采用受试者工作特征(Receiver operator characteristic curve,ROC)曲线分析INHB、AMH及IL-21水平对卵巢良性肿瘤患者卵巢储备功能的评估价值,采用Pearson分析AFC值与INHB、AMH及IL-21水平的相关性。结果与本组术前相比,术后3个月两组患者血清INHB、AMH水平均降低,IL-21水平均升高(P<0.05)。与正常组术后3个月相比,低功能组血清IL-21水平升高,INHB、AMH水平降低;卵泡刺激素(Follicle stimulating hormone,FSH)、黄体生成激素(Luteinizing hormone,LH)水平升高,雌二醇(Estradiol,E2)水平较低(P<0.05)。Logistic回归模型分析显示,术后3个月时血清IL-21水平是卵巢良性肿瘤患者卵巢储备功能低下的独立危险因素,血清INHB、AMH水平是其保护因素(P<0.05)。ROC曲线分析显示,术后3个月时患者血清INHB、AMH及IL-21水平诊断卵巢储备功能的AUC(95%CI)分别为0.707(0.610~0.792)、0.731(0.635~0.813)、0.802(0.712~0.873),联合评估的AUC(95%CI)为0.866(0.785~0.925),联合检测对卵巢储备功能低下的评估价值高于单项指标应用(P<0.05)。Pearson相关性分析显示卵巢良性肿瘤患者中血清INHB、AMH水平与AFC呈正相关(r=0.554、0.617,P均<0.05),血清IL-21水平与AFC呈负相关(r=-0.466,P<0.05)。结论术后3个月的血清INHB、AMH及IL-21水平与卵巢良性肿瘤患者卵巢储备功能具有密切相关性,三者联合应用对卵巢良性肿瘤患者术后卵巢储备能力的评估有重要参考价值。

Objective To analyze the correlation between serum levels of inhibin B(INHB),anti-mullerian hormone(AMH),and interleukin-21(IL-21)and ovarian reserve function in patients with benign ovarian tumors.Methods 104 patients with benign ovarian tumors admitted to the hospitalfrom January 2020 to December 2023 were collected as study subjects.According to the antral follicle count(AFC)at 3 months after surgery,the patients were divided into a low ovarian reserve group(n=46)and a normal group(n=58).The general information preoperative and 3-month postoperative serum levels of INHB,AMH and IL-21 of 2 groups of the patients were compared.Multivariate Logistic regression model was used to ana-lyze the influencing factors of ovarian reserve function in patients with benign ovarian tumors.Receiver op-erator characteristic curve(ROC)was used to analyze the evaluation value of INHB,AMH and IL-21 lev-els on ovarian reserve function in patients with benign ovarian tumors.The correlations between AFC and INHB,AMH and IL-21 levels were analyzed by Pearson.Results Compared with preoperative,both groups of the patients showed a decrease in serum INHB and AMH levels and an increase in IL-21 levels at 3 months postoperatively(P<0.05).Compared with the normal group at 3 months after surgery,the low function group showed an increase in serum IL-21 levels and a decrease in INHB and AMH levels(P<0.05),and the low functional group had higher levels of follicle stimulating hormone(FSH)and luteini-zing hormone(LH),and lower levels of estradiol(E2)(P<0.05);Logistic regression analysis showed that serum IL-21 levels at 3 months after surgery were an independent risk factor for ovarian reserve dys-function in patients with benign ovarian tumors,while INHB and AMH levels were protective factors(P<0.05).ROC curve analysis showed that at 3 months after surgery,the AUC(95%CI)for diagnosing o-varian reserve function based on serum INHB,AMH and IL-21 levels in patients were 0.707(0.610~0.792),0.731(0.635~0.813)and 0.802(0.712~0.873),respectively.The AUC(95%CI)for com-bined assessment was 0.866(0.785~0.925).The value of combined detection in evaluating ovarian re-serve function was higher than that of single indicator application(P<0.05).Pearson correlation analysis showed that serum levels of INHB and AMH were positively correlated with AFC in patients with benign ovarian tumors(r=0.554,0.617,both P<0.05),while serum levels of IL-21 were negatively correlated with AFC(r=-0.466,P<0.05).Conclusion Serum INHB,AMH and IL-21 levels at 3 months after surgery are closely correlated with ovarian reserve function in patients with benign ovarian tumors.The combined application of the three levels has important reference value for the evaluation of ovarian reserve ability in patients with benign ovarian tumors.