本文選題：多囊卵巢綜合征　切入點(diǎn)：體外受精/卵細(xì)胞漿內(nèi)單精子注射-胚胎移植　出處：《寧夏醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的探究多囊卵巢綜合征(PCOS)患者卵泡液中內(nèi)脂素、網(wǎng)膜素-1及代謝成分在體外受精-胚胎移植(IVF-ET)中對(duì)卵泡生長(zhǎng)、胚胎發(fā)育及妊娠結(jié)局的作用。方法選取2015年10月-2016年6月在寧醫(yī)大總院生殖醫(yī)學(xué)中心接受IVF/ICSI-ET的患者共130例。采用長(zhǎng)方案或拮抗劑方案,根據(jù)2003年鹿特丹診斷標(biāo)準(zhǔn),將患者分為PCOS組及非PCOS組。以BMI作為判斷肥胖的標(biāo)準(zhǔn),肥胖組:BMI≥25kg/m2,體重正常組:18.5kg/m2≤BMI25kg/m2。根據(jù)BMI將上述兩組進(jìn)一步分為兩亞組,共四組:A正常體重PCOS組;B:肥胖PCOS組;C:正常體重對(duì)照組;D:肥胖對(duì)照組。記錄患者一般情況、血清激素水平(b FSH,b LH,b E2、T)、COH及IVF結(jié)局;測(cè)定卵泡液及血清中內(nèi)脂素、網(wǎng)膜素-1水平及血脂水平(TC、TG、HDL、LDL)。結(jié)果1.PCOS患者卵泡液中內(nèi)脂素濃度及TC濃度顯著高于非PCOS組(8.91±7.93 VS2.38±3.01、0.76±0.16 VS 0.68±0.18,P0.05);網(wǎng)膜素-1濃度及HDL濃度顯著低于非PCOS組(138.02±181.88 VS 524.42±469.92、0.51±0.13 VS 0.51±0.13,P0.05);PCOS組血清中TG濃度明顯高于非PCOS患者(1.62±1.09 VS 1.21±0.61,P0.05)。2.按BMI分層:1)A組與B組比較:A組血清中TC、TG、LDL均顯著低于B組(4.14±0.67 VS 4.78±0.97、1.21±0.72 VS 2.25±1.26、2.02±0.53 VS 2.68±0.85,P0.05),HDL顯著高于B組(1.35±0..26 VS 1.01±0.30,P0.05);2)A組與C組比較:A組卵泡液中內(nèi)脂素、TC顯著高于C組(8.25±8.17 VS 2.75±3.87、0.79±0.16 VS 0.64±0.15,P0.05),網(wǎng)膜素-1及HDL顯著低于C組(156.49±218.21 VS 424.94±476.18、0.49±0.14VS 0.64±0.14,P0.05);3)B組與D組比較:B組卵泡液內(nèi)脂素、TG、LDL顯著高于D組(9.89±7.59 VS 1.96±1.75、0.22±0.08 VS 0.20±0.06、0.27±0.31 VS 2.23±0.62,P0.05),網(wǎng)膜素-1濃度顯著低于D組(101.95±60.04 VS 585.53±449.53,P0.05),B組血清中TG、LDL顯著高于D組(2.25±1.26 VS 1.47±0.61、2.68±0.85 VS 2.23±0.62,P0.05),HDL濃度顯著低于D組(1.01±0.30 VS 1.16±0.27,P0.05);4)C組與D組比較:C組卵泡液中TG、LDL濃度顯著低于D組(0.16±0.02 VS 0.20±0.06、0.08±0.09VS 2.23±0.62,P0.05),C組血清中TG濃度顯著低于D組(0.97±0.52 VS 1.47±0.61,P0.05),HDL濃度顯著高于D組(1.40±0.24 VS 1.16±0.27,P0.05);其余指標(biāo)各組間差異無統(tǒng)計(jì)學(xué)意義(P0.05)。3.PCOS組獲卵數(shù)、MII卵數(shù)、受精數(shù)、卵裂數(shù)、卵裂率均顯著高于非PCOS組(19.16±9.97 VS 14.31±7.35、15.43±8.29 VS 11.45±5.80、12.62±6.97 VS 10.34±5.49、12.22±6.92 VS 9.73±5.44,96.85%VS 94.07%,P0.05);PCOS組受精率明顯低于非PCOS組(81.79%VS 90.28%,P0.05)。4.PCOS患者卵泡液中內(nèi)脂素濃度與獲卵數(shù)(r=0.546,P0.05)、優(yōu)胚數(shù)(r=0.479,P0.05)呈正相關(guān);PCOS患者卵泡液中網(wǎng)膜素-1濃度與BMI(r=-0.667,P0.05)、LDL(r=-0.498,P0.05)呈負(fù)相關(guān),與卵泡液中HDL(r=0.582,P0.05)呈正相關(guān)。5.妊娠組內(nèi)脂素濃度明顯高于未妊娠組(6.91±7.57 VS 4.75±6.11,P0.05);妊娠組網(wǎng)膜素-1濃度明顯低于未妊娠組(277.98±361.75 VS 406.23±448.73,P0.05)。結(jié)論1.PCOS患者卵泡液中內(nèi)脂素水平升高及網(wǎng)膜素-1水平降低,在排除體質(zhì)因素的影響后,該結(jié)論仍成立,提示內(nèi)脂素及網(wǎng)膜素-1或許可以作為預(yù)測(cè)PCOS指標(biāo)之一。2.PCOS患者卵泡液中內(nèi)脂素含量與獲卵數(shù)及優(yōu)胚數(shù)呈正相關(guān),網(wǎng)膜素濃度與BMI、LDL呈負(fù)相關(guān),與HDL呈正相關(guān),提示針對(duì)PCOS患者卵泡局部微環(huán)境中內(nèi)脂素濃度調(diào)控可能會(huì)改善妊娠結(jié)局;3.卵泡液中內(nèi)脂素、網(wǎng)膜素-1濃度可能是預(yù)測(cè)IVF患者妊娠結(jié)局的良好指標(biāo)之一。
[Abstract]:Objective to explore the polycystic ovary syndrome (PCOS) patients with follicular fluid visfatin, omentin and -1 metabolites in in vitro fertilization and embryo transfer (IVF-ET) on follicular growth, embryo development and pregnancy outcomes. Methods from October 2015 June -2016 year in Nanjing Medical University General Hospital Reproductive Medical Center for patients undergoing IVF/ICSI-ET were in 130 cases. The long program or antagonist, according to the diagnosis standard of Rotterdam in 2003, the patients were divided into PCOS group and non PCOS group. Using BMI as the criteria for obesity, obesity group: BMI = 25kg/m2, 18.5kg/m2 = BMI25kg/m2.: normal weight group according to the BMI of the two groups were further divided into two sub groups, a total of the four group: A group PCOS B: group PCOS normal weight; obesity; C: normal weight control group; D: obese control group. Record the general condition of patients, serum hormone levels (B, FSH, B, LH, B, E2, T, COH and IVF) outcome; determination of follicular fluid and serum visfatin, 緗戣啘绱，

本文編號(hào)：1604370