抗苗勒氏管激素评价子宫肌瘤剔除术后卵巢功能的改变.docxVIP

抗苗勒氏管激素评价子宫肌瘤剔除术后卵巢功能的改变王海英1，梁洁玲1*，张仁礼1，毕燕玲2，罗怀钦1，蒋洲梅1,闻安民11.广东省人民医院/广东省医学科学院妇产科生殖医学，2.广东省人民医院检验科，广东，广州 510080摘要：目的：通过检测新的卵巢功能指标抗苗勒氏管激素(AMH)，评估子宫肌瘤剔除术对于年轻患者卵巢功能的影响。方法：前瞻性队列观察研究，选取36至45岁因子宫肌瘤行子宫肌瘤剔除术患者35名，于术前2天，术后2天及术后3月检测血清AMH，促卵泡生成素(FSH），促黄体生成激素(LH)水平，选取同年龄组未行手术的35例子宫肌瘤患者为对照组，检测前后3个月的血清AMH，FSH，LH水平变化。两组间及各时间点差异采用重复性检验方差分析及配对设计t检验分析。结果：1，子宫肌瘤剔除组患者术前、术后2天、术后3月AMH水平分别为1.54±0.95ng/ml，1.18±0.77ng/ml，1.50±0.58ng/ml，术后2天较术前AMH水平显著性降低(p0.05)，术后3月逐步回升，与术前相比无差异改变(p0.05)。2，未行手术组患者3个月AMH水平无差异性改变。3，子宫肌瘤切除组与对照组各时间点AMH水平变化是有差异的(p0.05)，而FSH，LH水平变化是无差异的(p0.05)。结论：1、AMH评估卵巢功能的改变优于FSH，LH。2、子宫肌瘤剔除术短期影响卵巢功能，但3个月后恢复，手术与术中出血可能会暂时性影响AMH水平下降。关键词：抗苗勒氏管激素，子宫肌瘤剔除术，卵巢功能The effect on ovarian function after myomectomy as assessed by serum anti-Mullerian hormone levelsWang Haiying1, Liang Jieling1,Zhang Renli1,Bi Yanlin2, Luo Huaiqin1, Jiang Zhoumei1,Wen Anmin1Center of Reproductive Medicine1andLaboratory Medicine2,Guangdong General Hospital, Guangdong /Academy of Medical Sciences, Guangzhou 510080, ChinaAbstract: Objective The aim of this prospective study was to evaluate the changes in the ovarian reverse after myomectomy based on serum anti-MullerianHormone(AMH) levels. Methods This is a prospective longitudinal observational study. Serum AMH levels were measured at the baseline and 2 day,3months after myomectomy in 35 women in age range from 36 to 45years.Follicle stimulate hormone(FSH)and lutealhormone(LH)were measured at the same time. The study subjects and controls were analyzed using repeated measure ANOVA and using t test or one-way analysis of variance. Result:1.There were serial change in the myomectomy group. The mean levels of serum AMH at each time point (1.54±0.95ng/ml ng/ml[pre-operatively]， 1.18±0.77ng/ml[2 day post-hysterectomy]， 1.50±0.58ng/ml [three months post-hysterectomy];p0.05);.No different existed between baseline and post3months (p0.05), but significant different existed between baseline and post2 day(p0.05).2.Significant differences in the serial change of AMH levels