生殖医学杂志

目的探讨血清抗子宫内膜抗体(EMAb)水平对多囊卵巢综合征(PCOS)合并不孕症的预测价值。方法收集2018年6月至2019年6月我院生殖医学科收治的112例PCOS合并不孕症患者作为研究对象(PCOS组),选取同期于我院体检中心进行孕前体检的60例健康妇女作为对照组。收集2组受试者的血清标本,采用酶联免疫吸附(ELISA)试验法检测血清EMAb水平,采用电化学发光法检测血清FSH、LH、孕酮、E₂等性激素水平。利用受试者工作曲线分析血清EMAb对PCOS合并不孕的预测价值,采用Pearson相关性分析血清EMAb与性激素水平的相关性。结果两组受试者的年龄、体重指数(BMI)、FSH等一般资料比较无显著性差异(P>0.05);PCOS组的EMAb、T、LH水平显著高于对照组,孕酮、E₂水平显著低于对照组(P<0.05)。Logistic回归分析结果显示,EMAb、LH、孕酮是PCOS合并不孕症的独立危险因素(P均<0.05)。血清EMAb鉴别PCOS合并不孕症的AUC为0.959,LH、孕酮的分别为0.771、0.844;血清EMAb检测的诊断价值显著高于LH、孕酮检测(P<0.05)。PCOS组血清EMAb与LH呈正相关,与孕酮呈负相关关系(P均<0.05)。结论 PCOS合并不孕症患者血清EMAb水平显著升高,且与性激素水平显著相关;血清EMAb水平可作为预测PCOS合并不孕症的指标。

Objective:To investigate the predictive value of serum endometrium antibody(EMAb)level in the patients with polycystic syndrome(PCOS).Methods:A total of 112 infertile patients with PCOS admitted to the hospital from June 2018 to June 2019 as PCOS group,and 60 healthy women who had pre-pregnancy physical examination at the same time were selected as control group. Five ml blood samples were collected from patients of two groups. The serum EMAb levels were detected by enzyme-linked immunosorbent assay(ELISA),and serum FSH,testosterone(T),LH,progesterone,estradiol(E₂)levels were detected by electrochemiluminescence method. Predictive value of serum endometrium antibody levels was analyzed by using receiver operating characteristic curve(ROC). The correlation between serum EMAb level and sex hormone levels were analyzed by using Pearson correlation analysis.Results:There were no significant differences in the general data including age,BMI and FSH between the two groups(P>0.05). The EMAb,T and LH levels in the PCOS group were significantly higher than those in the control group,but progesterone and E₂ levels were significantly lower than the control group(P<0.05). Logistic regression analysis showed that EMAb,LH,and P were independent risk factors for polycystic syndrome with infertility(P<0.05). The area under curve(AUC)of serum EMAb in identification of polycystic syndrome with infertility was 0.959,which was significantly higher than the AUC of LH(0.771)and progesterone(0.844)(P<0.05). Serum EMAb was positively correlated with LH,but negatively correlated with progesterone in PCOS group(P<0.05).Conclusions:Serum EMAb levels in the infertile patients with polycystic ovary syndrome are significantly elevated,and serum EMAb levels were positively correlated with sex hormone levels. Serum EMAb level can be used as a predictor of polycystic syndrome with infertility.