超排卵治疗中VEGF和E_2对OHSS的预测作用

The forecasting role of VEGF and E_2 in OHSS during superovulation in women with infertility

目的 检测超排卵治疗的不孕症患者血清血管内皮生长因子 (VEGF)和雌二醇 (E2 )水平 ,探讨VEGF和E2 对卵巢过度刺激综合征 (OHSS)的预测作用。方法 采集 4 1例高危患者注射HCG前和注射后 34～ 36h血清标本 ,测定VEGF和E2 水平 ,并与同期 30例非高危病人进行对照。结果 高危各组在注射HCG前 ,血清VEGF水平与对照组无显著性差别 (P >0 0 5 ) ,注射后OHSS组VEGF水平明显升高 (P <0 0 1) ,显著高于对照组和非OHSS组 (P <0 0 1) ;高危各组E2 水平在注射HCG日显著高于对照组 ,注射后OHSS组E2 水平与注射前比明显升高 (P <0 0 1) ,显著高于对照组 (P <0 0 1) ,但非OHSS组变化不明显 (P >0 0 5 )。结论 VEGF在HCG注射后可作为预测OHSS的标志物 ,结合连续测定E2 水平 ,有助于预测和治疗卵巢过度刺激综合征。

Objective To determine the predictive value of VEGF and E_ 2 in patients with OHSS by measuring VEGF and E_ 2 from the serum samples in patients undergoing superovulation.Methods Blood samples were collected from 41 high risk patients and 30 control patients undergoing superovulation on the day of hCG administration and after 34～36 hours of hCG administration. VEGF and E_ 2 were detected and then the difference between high risk group and control group were analyzed.Results There was no significant difference in VEGF between high risk group and control group on the day of hCG injection( P >0.05).After hCG administration,concentrations of VEGF increased significantly in OHSS group ( P <0.01).At the time of hCG administration,the serum E_ 2 levels of high-risk patients were significantly higher than those of the control groups.E_ 2 concentrations of OHSS group increased obviously after HCG injection ( P <0.01) and were significantly higher than those of the control group ( P <0.01),but there was no statistically significant change in E_ 2 concentrations in non-OHSS group ( P >0.05). Conclusion The results show that VEGF cannot play the predictive role in OHSS on the day of hCG administration, but it may be considered as a predictive marker for the development of OHSS after hCG administration. Combining serum VEGF concentrations with consecutive E_ 2 measurement can assist in predicting and treating OHSS.