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目的探讨血清抑制素B(INHB)水平测定,在评价卵巢储备力和调节控制性超排卵用药中的意义。方法选择96例接受体外受精-胚胎移植(IVF-ET)治疗的患者,根据超排卵用药反应分3组:低度反应组(6例)、中度反应组(72例)、高度反应组(18例)。在经期第3天采用酶联免疫吸附法(ELISA)测定血清INHB水平;采用化学发光法测定血清基础卵泡刺激素(FSH)、黄体生成素(LH)和人绒毛膜促性腺激素(hCG)注射日雌二醇水平;计算周期获卵数、优质胚胎数、周期妊娠率,以调节控制性超排卵用药。结果低度反应组、中度反应组、高度反应组INHB水平分别为(28±20)、(85±42)、(92±34)pg/ml;FSH水平分别为(11·9±5·3)、(7·5±2·6)、(7·2±1·7)U/L;hCG注射日雌二醇水平分别为(2558±2108)、(9366±4472)、(18392±9655)pmol/L;周期获卵数分别为(0·6±0·4)、(8·7±3·6)、(14·3±2·9)个;优质胚胎数分别为(0·4±0·3)、(3·8±1·9)、(4·6±1·7)个;周期妊娠率分别为16·7%、36·1%、61·1%。INHB水平与FSH水平、FSH/LH比值呈负相关(r分别为-0·222,-0·371,P<0·05),与hCG注射日雌二醇水平、周期获卵数、优质胚胎数、周期妊娠率呈正相关(r分别为0·336、0·404、0·323、0·246,P<0·05)。低度反应组、中度反应组、高度反应组在控制性超排卵中,基因重组FSH用量分别为(3808±742)、(3046±709)、(2158±653)U。结论INHB测定可作为预测卵巢储备力的直接指标,在辅助生育治疗中,对指导控制性超排卵用药有重要临床意义。
Objective To investigate the value of serum inhibin B (INHB) in the evaluation of ovarian reserve and the regulation of controlled ovarian hyperstimulation. Methods Ninety-six patients undergoing IVF-ET were enrolled in this study. According to the response to superovulation, three groups were divided into three groups: low response group (6 cases), moderate response group (72 cases) and high response group 18 cases). Serum INHB levels were measured by enzyme-linked immunosorbent assay (ELISA) on the third day of menstruation; serum basic follicle stimulating hormone (FSH), luteinizing hormone (LH) and human chorionic gonadotropin (hCG) injection Day estradiol levels; calculate the number of oocytes retrieved, the number of high-quality embryos, cycle pregnancy rate, in order to regulate the control of superovulation medication. Results The levels of INHB in the low response group, the moderate response group and the high response group were (28 ± 20), (85 ± 42) and (92 ± 34) pg / ml respectively and the levels of FSH were (11 · 9 ± 5 · 3, 7.5 ± 2.6 and 7.2 ± 1.7, respectively. The estradiol levels on the day of hCG injection were (2558 ± 2108), (9366 ± 4472) and (18392 ± 9655) pmol / L, respectively. The number of oocytes obtained in the cycle was (0 · 6 ± 0.4), (8.7 ± 3.6) and (14.3 ± 2.9) · 4 ± 0 · 3), (3 · 8 ± 1 · 9) and (4.6 · 1 · 7) respectively. The rate of pregnancy was 16.7%, 36.1% and 61.1% respectively. The level of INHB was negatively correlated with the level of FSH and the ratio of FSH / LH (r = -0.222, -0.371, P <0.05), which correlated with the level of estradiol, Number of cycles and pregnancy rates were positively correlated (r = 0.336, 0.404, 0.323, 0.246, P <0.05). In the control group, the rates of recombinant human FSH were (3808 ± 742), (3046 ± 709) and (2158 ± 653) U, respectively, in the low response group, moderate response group and high response group. Conclusion INHB assay can be used as a direct index to predict ovarian reserve. It has important clinical significance in guiding the controlled ovarian hyperstimulation during assisted reproductive therapy.