生殖医学杂志

目的 探讨心率变异性(HRV)中高频功率(HF)与接受体外受精/卵胞浆内单精子注射-胚胎移植(IVF/ICSI-ET)治疗的不孕患者妊娠结局的相关性。方法 对2022年1—6月于邢台不孕不育专科医院接受IVF/ICSI-ET治疗的329例女性患者的临床资料进行回顾性分析。将研究对象根据HF水平按三分位法分成A组(HF 7.91～197.06,n=110)、B组(HF 198.22～358.03,n=109)和C组(HF 360.03～3 121.14,n=110),比较3组患者的心理测评结果[焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分]、子宫内膜情况及妊娠结局。采用Spearman相关分析HF水平与心理状况及结局指标的相关性。结果 3组间患者一般资料及基础内分泌水平等比较均无统计学差异(P>0.05)。3组间SAS评分存在显著性差异(P<0.05),其中C组SAS评分显著低于A组(P<0.05);3组间SDS评分比较无统计学差异(P>0.05)。子宫内膜容受性方面，C组内膜血流搏动指数、子宫内膜蠕动波频率均显著低于A、B组[分别为(1.68±0.59) vs.(1.97±0.39)、(1.88±0.39);(1.76±0.93) vs.(2.68±1.58)、(2.30±1.36)](P<0.05)。胚胎结局方面，C组的正常受精率显著高于A、B两组(66.59%vs. 60.03%、63.03%,P<0.05),种植率显著高于A组(54.49%vs. 40.96%,P<0.05)。相关性分析结果显示，HF水平与SAS评分、蠕动波频率呈负相关(P<0.01),与种植率呈正相关(P<0.05)。结论 HRV中的HF可能反映了机体对心理压力的调整能力；较高的HF水平可能预示着较好的子宫内膜容受性及种植率；医务人员应重视HRV的检测，及时进行干预，适当提高其HF水平。

Objective:To explore the correlation between high frequency power(HF) in heart rate variability(HRV) and pregnancy outcomes of patients undergoing IVF-ET.Methods:Clinical data of 329 patients received IVF/ICSI-ET in Xingtai Infertility Specialist Hospital from January 2022 to June 2022 were analyzed retrospectively. According to the tertiles of HF levels, the patients were divided into three groups, group A(HF 7.91-197.06,n=110),group B(HF 198.22-358.03,n=109) and group C(HF 360.03-3 121.14,n=110). The results of psychological assessment results[self-rating anxiety scale(SAS) score, self-rating depression scale(SDS) score],endometrial condition, and pregnancy outcome were compared among the three groups. Spearman correlation was used to analyze the correlation between HF and SAS,SDS scores and pregnancy outcome indicators.Results:There was no difference in general information and basic endocrinology hormone level among the three groups. There was a significant difference in the SAS score among the three groups(P<0.05). The SAS score of group C was significantly lower than that of group A(P<0.05). There was no significant difference in the SDS score among the three groups(P>0.05). In terms of endometrial receptivity, the pulsatility index(PI) of endometrial blood flow[(1.68±0.59) vs.(1.97±0.39),(1.88±0.39)],the frequency of endometrial peristalsis[(1.76±0.93) vs.(2.68±1.58),(2.30±1.36)] in group C were significantly lower than those in group A and group B(all P<0.05). In terms of embryonic outcomes, the fertilization rate of group C was significantly higher than that of group A and group B(66.59% vs. 60.03%,63.03%,P<0.05),and implantation rate(54.49% vs. 40.96%) was significantly higher than that of groups A(P<0.05). The correlation analysis results showed that HF was negatively correlated with SAS score and peristaltic wave frequency(P<0.01),and positively correlated with implantation rate(P<0.05).Conclusions:HF in HRV may reflect the body's good ability to regulate psychological stress. A higher HF may indicate better endometrial receptivity and implantation rate. Medical personnel should attach importance to the detection of HRV,intervene in a timely manner, and appropriately increase their HF level.