摘要
目的探讨未累及卵巢的盆腔子宫内膜异位病灶电灼术对患者血清抗苗勒管激素(AMH)水平及卵巢储备功能的影响。方法选择不合并卵巢子宫内膜异位囊肿进行电灼术的18例子宫内膜异位症(EMS)患者为EMS组,同期因子宫肌瘤行腹腔镜剔除术且无不良孕产史的12例患者为对照组,比较EMS组与对照组患者在术前及术后1、3、6个月的血清AMH水平,分析EMS组患者术前及术后1、3、6个月的促黄体生成素(LH)、促卵泡生成素(FSH)、雌二醇水平变化。结果 2组患者在术前的血清AMH水平比较差异无统计学意义(P>0.05),EMS组患者在术后1、3、6个月的血清AMH水平均低于对照组(P均<0.05)。与术前相比,EMS组患者在术后1个月的血清AMH、雌二醇水平下降,LH、FSH水平升高(P均<0.008);术后3个月,EMS组的FSH、雌二醇和LH水平已恢复至术前水平,术后6个月已趋向稳定状态,与术前比较差异均无统计学意义(P均>0.008);EMS组的血清AMH水平在术后3个月仍未恢复,术后6个月的血清AMH水平仍低于术前水平(P均<0.008)。结论未累及卵巢的盆腔子宫内膜异位病灶实施电灼术对卵巢储备功能有影响,术后半年是卵巢储备功能恢复期,且使用血清AMH作为卵巢储备功能评估指标优于FSH、雌二醇和LH。
Objective To evaluate the effect of electrocautery of endometriosis without ovarian le-sions upon the serum concentration of anti-Mlillerian hormone （ AMH） and ovarian reserve. Methods Eight-een patients diagnosed with endometriosis （EMS） without ovarian cyst undergoing electrocautery weinto the EMS group. During the same period, 12 patients without any adverse history of preglaparoscopic myomectomy were assigned into the control group. The AMH levels before,1 , 3 and 6 months af-ter surgery were statistically compared between the EMS and control groups. The variations in the serum con-centrations of luteotropic hormone （LH）, follicle-stimulating hormone （FSH） and estradiol between two groups were analyzed before,1,3 and 6 months after surgery. Results No statistical significance was noted in thepreoperative AMH levels between two groups （P 〉0. 05）. In the EMS group,the AMH levels 1,3 and 6 months were significantly lower compared with those in the control group （ all P 〈 0. erative 1 month, the levels of AMH and estradiol were significantly declined,whereas the level of FSH was considerably elevated in the EMS group （ both P 〈 0. 008 ）. At postoperative 3 months, the levels of FSH, es-tradiol and LH in the EMS group were restored to preoperative levels , and tended to stabilize at postoperative 6 months,which did not significantly differ from preoperative levels （ all P 〉 0. 008 ）. In the EMS group, the AMH level was not restored at postoperative 3 months,and still significantly lower than preoperative AMH lev-els （ both P 〈 0. 008 ）. Conclusions Electrocautery 〇 f edometriosis without ovarian lesions affects the ovarian reserve,which can recover within postoperative 6 months. Compared with FSH,estradiol and LH,AMH is a superior parameter to assess the ovarian reserve.
出处
《新医学》
2017年第11期804-807,共4页
Journal of New Medicine
基金
佛山市科技计划基金(2015AB001165)
