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目的 分析多囊卵巢综合征(PCOS)患者发生高同型半胱氨酸血症(HHCY)的危险因素。方法 回顾性分析2018年9月至2023年6月在兰州大学第二医院生殖医学科门诊就诊的387例PCOS患者的临床资料，根据血清同型半胱氨酸(HCY)水平是否≥15 mmol/L分为两组：病例组(HHCY组，n=108)和对照组(NHHCY组，n=279),比较两组间的外周血激素水平及生化指标，单因素及多因素Logistic分析PCOS患者罹患HHCY的危险因素，采用Pearson统计分析HCY水平与血清激素、生化指标间的相关性。结果 与对照组比较，病例组年龄较小，且血中总胆红素(TBil)、直接胆红素(DBil)、间接胆红素(IBil)、尿素(Urea)及肌酐(Cr)水平均显著高于对照组(P<0.05)。多因素Logistic回归分析显示，Urea [OR=1.204,95%CI(1.010,1.435)]是PCOS患者发生HHCY的独立危险因素(P<0.05)。相关性分析显示，PCOS患者血清T(r=0.119,P=0.023)、TBil(r=0.130,P=0.011)、IBil(r=0.103,P=0.042)、DBil(r=0.113,P=0.026)和Urea(r=0.113,P=0.026)与HCY呈显著正相关，年龄(r=-0.108,P=0.035)与HCY呈显著负相关。结论 血清高尿素水平与PCOS患者发生HHCY存在关联，胆红素代谢对PCOS患者发生HHCY的风险发挥着潜在作用。
Abstract：Objective:To analyze the risk factors of hyperhomocysteinemia(HHCY) in patients with PCOS.Methods:The clinical data of 387 PCOS patients who were treated in the Department of Reproductive Medicine of the Second Hospital of Lanzhou University from September 2018 to June 2023 were retrospectively analyzed. According to whether the homocysteine(HCY) level was not less than 15 mmol/L,the patients were divided into two groups as the case group(HHCY group, n=108) and the control group(NHHCY group, n=279). The hormone levels and biochemical indicators between the two groups were compared. The univariate and logistic multivariate analyses were used to analyze the risk factors of HHCY in PCOS patients. Pearson statistical analysis was used to analyze the correlation between HCY and serum hormones and biochemical indicators.Results:Compared with the control group, the age of the case group was younger, and the levels of total bilirubin(TBil),direct bilirubin(DBil),urea, and creatinine(Cr) were higher than those of the control group(P<0.05). Logistic regression analysis showed that urea [OR=1.204,95%CI(1.010,1.435)] was an independent risk factor for HHCY in patients with PCOS(P<0.05). Correlation analysis showed that serum levels of testosterone(r=0.119,P=0.023),TBil(r=0.130,P=0.011),IBil(r=0.103,P=0.042),DBil(r=0.113,P=0.026),and urea(r=0.113,P=0.026) were positively correlated with HCY in PCOS patients, and age(r=-0.108,P=0.035) was negatively correlated with HCY.Conclusions: High serum urea level is an independent risk factor of HHCY in patients with PCOS. Bilirubin metabolism plays a potential role in the risk of HHCY in PCOS patients.
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基本信息:
中图分类号:R711.75
引用信息:
[1]杨岩婷,虎宁,刘琳,等.PCOS患者发生高同型半胱氨酸血症的危险因素分析[J].生殖医学杂志,2025,34(06):728-734.
基金信息:
国家自然科学基金项目(82460306); 甘肃省兰州市兰州大学科研项目(054000229); 甘肃省卫生健康行业研究项目(GSWSKY2024-04); 甘肃省兰州市科技计划项目; 兰州大学第二医院“萃英科技创新”计划研究项目(CY2022-MS-B03); 甘肃省兰州市兰州大学第二医院科研项目(CY2023-MS-B13)
2025-06-15
2025-06-15