文章摘要

血清抗苗勒管激素、促卵泡生成激素、促黄体生成素及雌二醇水平对腹腔镜下卵巢巧克力囊肿剥除术患者卵巢功能的评估价值

作者: 1汤云仙, 1蔡怡琦, 1沈连强, 1陆维仙, 2许中, 1杨如
1 苏州市立医院妇产科,江苏 苏州 215000
2 苏州市立医院检验科,江苏 苏州 215000
通讯: 杨如 Email: 190079916@qq.com
DOI: 10.3978/j.issn.2095-6959.2020.09.016
基金: 苏州市科技局项目(KJXW2016028)。

摘要

目的:探讨血清抗苗勒管激素(anti-Mullerian hormone,AMH)、促卵泡生成激素(follicle stimulating hormone,FSH)、促黄体生成素(luteinizing hormone,LH)和雌二醇(estradiol,E2)水平检测对腹腔镜下卵巢巧克力囊肿剥除术患者卵巢功能的评估价值。方法:共选取2016年10月1日至2018年12月31日在苏州市立医院行腹腔镜下巧克力囊肿剥除术的50例患者,记为观察组,年龄20~40岁,根据囊肿部位分为单侧组(n=29)与双侧组(n=21),分别于术前、术后1个月、3个月和6个月时检测血清AMH和内分泌激素FSH,LH和E2水平,评估手术前后卵巢功能变化。结果:患者均成功完成手术,且术后至少随访6个月。与术前比较,观察组术后1个月、3个月、6个月AMH水平均有明显下降(P<0.05或P<0.01),术后1个月FSH水平有显著升高(P<0.01)。术后3个月、6个月FSH水平和术后各时点LH,E2水平与术前比较,差异均无统计学意义(P>0.05)。单侧组术后1个月、3个月血清AMH水平较术前明显下降(P<0.05或P<0.01),术后6个月与术前比较,差异无统计学意义(P>0.05),双侧组术后各时点血清AMH水平均显著低于术前(P<0.05或P<0.01)。单侧组和双侧手术前后各时点血清FSH,LH和E2水平比较,差异均不显著(P>0.05),但双侧组术后3个月、6个月血清AMH水平显著低于单侧组,差异有统计学意义(P<0.05或P<0.01)。结论:腹腔镜卵巢巧克力囊肿剥除术易导致患者卵巢功能下降,且双侧卵巢巧克力囊肿患者术后卵巢功能下降更为明显,常规检测FSH,LH,E2的同时重点加强血清AMH检测对临床准确评估术后卵巢功能变化具有显著指导价值。
关键词: 腹腔镜下卵巢巧克力囊肿剥除术;卵巢功能;血清抗苗勒管激素;内分泌激素

Value of serum anti-Mullerian hormone, follicle stimulating hormone, luteinizing hormone, and estradiol levels in evaluating ovarian function in patients with laparoscopic chocolate cyst removal

Authors: 1TANG Yunxian, 1CAI Yiqi, 1SHEN Lianqiang, 1LU Weixian, 2XU Zhong, 1YANG Ru
1 Department of Obstetrics and Gynecology, Suzhou Municipal Hospital, Suzhou Jiangsu 215000, China
2 Department of Clinical Laboratory, Suzhou Municipal Hospital, Suzhou Jiangsu 215000, China

CorrespondingAuthor: YANG Ru Email: 190079916@qq.com

Foundation: This work was supported by the Project of Suzhou Science and Technology Bureau, China (KJXW2016028).

Abstract

Objective: To evaluate the value of serum anti-Mullerian hormone (AMH), follicle stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E2) levels in evaluating ovarian function in patients undergoing laparoscopic ovarian chocolate cyst dissection. Methods: A total of 50 patients who aged 20–40 years old underwent laparoscopic chocolate cyst removal in Suzhou Municipal Hospital from October 1, 2016 to December 31, 2018 were enrolled in the observation group. They were divided into an unilateral group (n=29) and a bilateral group (n=21) according to the location of the cyst. They were detected before operation, 1 month, 3 months and 6 months after operation. Serum levels of AMH and endocrine hormones FSH, LH and E2 were measured to evaluate the changes of ovarian function before and after operation. Results: All patients successfully completed the operation and were followed up for at least 6 months. Compared with those before operation, AMH levels in the observation group decreased significantly at 1 month, 3 months and 6 months after operation (P<0.05 or P<0.01), and FSH levels increased significantly at 1 month after operation (P<0.01). There was no significant difference in FSH levels at 3 months and 6 months after operation and LH and E2 levels at all time points after operation (P>0.05).The level of serum AMH in unilateral group decreased significantly at 1 and 3 months after operation (P<0.05 or P<0.01). There was no significant difference between the two groups at 6 months after operation (P>0.05). The level of serum AMH in bilateral group was significantly lower at all time points after operation than that before operation (P<0.05 or P<0.01). There was no significant difference in serum FSH, LH and E2 levels between unilateral group and bilateral group at all time points before and after operation (P>0.05), but serum AMH levels in bilateral group were significantly lower than those in unilateral group at 3 months and 6 months after operation (P<0.05 or P<0.01). Conclusion: Laparoscopic ovarian chocolate cyst removal can easily lead to the decline of ovarian function in patients with bilateral ovarian chocolate cyst, and the decline of ovarian function in patients with bilateral ovarian chocolate cyst is more obvious. Routine detection of FSH, LH and E2, while focusing on the detection of serum AMH, has important guiding value for clinical accurate evaluation of ovarian function changes after surgery.
Keywords: laparoscopic ovarian chocolate cyst dissection; ovarian function; serum anti-Mullerian hormone; endocrine hormone