抗苗勒氏管激素检测对子宫切除术后患者卵巢功能的评价

摘要

目的：探讨检测新的卵巢功能评价指标抗苗勒氏管激素（AMH）的价值，阐明子宫切除术对于年轻患者卵巢功能的影响。方法：选取36～45岁因子宫良性病变行全子宫切除术（子宫切除组）和同年龄段子宫肌瘤未行手术治疗（对照组）患者各35例，于不同时间点检测患者血清 AMH、促卵泡生成素（FSH）和促黄体生成激素（LH）水平，同时行阴道彩色多普勒超声监测卵巢动脉血流阻力指数（RI），分析不同时间点2组患者激素水平及卵巢动脉血流 RI的变化。结果：与术前比较，子宫切除组患者术后2 d及3个月 AMH 水平均明显降低（P＜0.05或P＜0.01）。与对照组比较，子宫切除组患者术后2 d及3个月血清 AMH 水平也明显降低（P＜0.05）。子宫切除组患者术后1和3个月卵巢动脉血流 RI较术前和对照组明显增高（P＜0.05）。子宫切除组和对照组患者不同时间点血清 FSH和 LH水平无明显变化（P＞0.05）。结论：子宫切除术影响年轻患者卵巢功能，术后3个月 AMH水平下降，卵巢血流阻力增高。以血清 AMH 水平评估卵巢功能的改变优于传统的FSH和 LH指标。%Objective To evaluate the value of the new ovarian function marker serum anti-Mullerian hormone (AMH)and to clarify the effect of hysterectomy on the ovarian function of the younger women.Methods The serum AMH,follicle stimulating hormone (FSH)and luteinizing hormone (LH)levels in 35 women suffered uterus benign lesion aged 36-45 years and 35 women suffered hysteromyoma without operation were measured at different time.And the ovarian arterial blood flow resistance index (RI ) was measured by Doppler ultrasound. Results Compred with before operation, the serum AMH levels of the patients in hysterectomy group 2 d and 3 months after operation were significantly decreased (P<0.05 or P<0.01).Compared with control group,the serum AMH levels of the patients in hysterectomy group 2 d and 3 months after operation were also decreased (P<0.05).The ovarian arterial blood flow RI of the patients in hysterectomy group 1 and 3 months after operation were increased compared with control group (P<0.05).There were no significant differences in the serum FSH and LH levels in each group between different time points (P>0.05).Conclusion Hysterectomy can affect the ovarian function,and the serum AMH level 3 months after operation is decreased and the ovarian arterial blood flow RI is increased.AMH is superior to FSH or LH in evaluating the changes of ovarian function.