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目的:探讨卵泡液中叉头框转录因子O亚族1（Forkhead box transcription factor O1，FoxO1）mRNA、天冬氨酸蛋白水解酶-3（Caspase-3）mRNA、生长分化因子-9（growth differentiation factor-9，GDF-9）水平与优质胚胎数的相关性及其预测不孕患者体外受精-胚胎移植（n in vitro fertilization-embryo transfer，IVF-ET）临床妊娠的效能。n 方法:选取2017年2月至2020年1月期间驻马店市中心医院收治的468例接受IVF-ET治疗的不孕患者进行病例对照研究，根据是否妊娠分为妊娠组（n n=248）、未妊娠组（n n=220），比较两组一般资料、取卵日性激素水平、卵泡液n FoxO1 mRNA、n Caspase-3 mRNA、GDF-9水平。采用Pearson分析卵泡液n FoxO1 mRNA、n Caspase-3 mRNA、GDF-9之间及其与优质胚胎数的相关性，采用logistic回归方程分析IVF-ET临床妊娠的相关因素并以受试者工作特征（receiver operating characteristic，ROC）曲线分析卵泡液n FoxO1 mRNA、n Caspase-3 mRNA、GDF-9预测临床妊娠的效能。n 结果:妊娠组优质胚胎数多于未妊娠组［（2.59±0.68）枚比（1.78±0.62）枚，n P<0.001］，基础卵泡刺激素（follicle-stimulating hormone，FSH）水平、基础黄体生成素（luteinizing hormone，LH）水平低于未妊娠组［（7.16±0.29）U/L比（6.21±0.34）U/L，（8.72±1.24）U/L比（10.65±1.01）U/L，均n P<0.001］，取卵日雌二醇高于未妊娠组［（848.18±50.68）ng/L比（605.35±46.79）ng/L，n P<0.001］。妊娠组n FoxO1 mRNA、GDF-9水平高于未妊娠组，n Caspase-3 mRNA水平低于未妊娠组（均n P<0.001）；n FoxO1 mRNA与n Caspase-3 mRNA呈负相关，与GDF-9呈正相关（均n P<0.001）；n Caspase-3 mRNA与GDF-9呈负相关（均n P<0.001）；n FoxO1 mRNA、GDF-9与优质胚胎数呈正相关，n Caspase-3 mRNA与优质胚胎数呈负相关（均n P<0.001）。多元线性回归分析显示，在排除混杂因素后，n FoxO1 mRNA、n Caspase-3 mRNA、GDF-9水平与优质胚胎数相关（均n P<0.001）。以IVF-ET临床妊娠为因变量，纳入优质胚胎数、基础FSH、基础LH、取卵日雌二醇、n FoxO1 mRNA、n Caspase-3 mRNA、GDF-9为自变量进行logistic回归方程分析，结果显示优质胚胎数、基础FSH、基础LH、取卵日雌二醇、n FoxO1 mRNA、n Caspase-3、GDF-9均与临床妊娠结局显著相关（均n P<0.001）。n FoxO1 mRNA、n Caspase-3 mRNA、GDF-9水平联合预测IVF-ET临床妊娠的曲线下面积（area under curve，AUC）值为0.891，大于n FoxO1 mRNA指标单独检测（AUC=0.796，n P=0.012）。n 结论:FoxO1 mRNA、n Caspase-3 mRNA、GDF-9水平与胚胎发育及性激素水平有关，且n FoxO1 mRNA、GDF-9水平升高，n Caspase-3 mRNA水平降低有利于临床妊娠，三者联合检测可为评价IVF-ET临床妊娠提供参考。n “,”Objective:To explore the correlation between Forkhead box transcription factor O1 (FoxO1) mRNA, n Caspase-3 mRNA, growth differentiation factor-9 (GDF-9) expression levels and the number of high-quality embryos and the efficacy of predicting n in vitro fertilization-embryo transfer (IVF-ET) clinical pregnancy in infertile patients.n Methods:A case-control study of 468 infertile patients who received IVF-ET treatment from February 2017 to January 2020 in Zhumadian Central Hospital was performed. According to whether pregnant, patients were divided into pregnancy group (n n=248) and non-pregnancy group (n n=220). We compared the general data, sex hormone levels on the day of egg retrieval, n FoxO1 mRNA, n caspase-3 mRNA, and GDF-9 levels in follicular fluid between the two groups. Pearson was used to analyze the relationship between n FoxO1 mRNA, n Caspase-3 mRNA, and GDF-9 in follicular fluid and the number of high-quality embryos. The logistic regression equation was used to analyze the related factors of IVF-ET clinical pregnancy. The receiver operating characteristic (ROC) curve was used to analyzed the efficacy of follicular fluid n FoxO1 mRNA, n Caspase-3 mRNA, GDF-9 in predicting clinical pregnancy.n Results:The number of high-quality embryos in pregnancy group was higher than that in non-pregnancy group (2.59±0.68 n vs. 1.78±0.62, n P<0.001), the basal follicle-stimulating hormone (FSH) and luteinizing hormone (LH) were lower than those in non-pregnancy group [(7.16±0.29) U/Ln vs. (6.21±0.34) U/L, (8.72±1.24) U/L n vs. (10.65±1.01) U/L, all n P<0.001] and the estradiol on the day of oocytes retrieved was higher than that of non-pregnancy group [(848.18±50.68) ng/Ln vs. (605.35±46.79) ng/L, n P<0.001].n FoxO1 mRNA and GDF-9 in pregnancy group were higher than those in non-pregnancy group, n Caspase-3 mRNA was lower than that in non-pregnancy group (n P<0.001).n FoxO1 mRNA was negatively correlated with n Caspase-3 mRNA and positively correlated with GDF-9 (n P<0.001),n Caspase-3 mRNA was negatively correlated with GDF-9 (n P<0.001).n FoxO1 mRNA and GDF-9 were positively correlated with the number of high-quality embryos, while n Caspase-3 mRNA was negatively correlated with the number of high-quality embryos (all n P<0.001). Multiple linear regression analysis showed that after excluding confounding factors, the levels ofn FoxO1 mRNA, n Caspase-3 mRNA, and GDF-9 were still correlated with the number of high-quality embryos (all n P<0.001). IVF-ET clinical pregnancy was taken as a dependent variable and the number of high-quality embryos, basic FSH, basic LH, estradiol,n FoxO1 mRNA, n Caspase-3 mRNA, and GDF-9 were included as independent variables for logistic regression analysis. The number of high-quality embryos, basic FSH, basic LH, estradiol on the day of oocytes retrieved, n FoxO1 mRNA, n Caspase-3 mRNA and GDF-9 were significantly correlated with clinical pregnancy (all n P<0.001). The area under curve (AUC) value ofn FoxO1 mRNA,n Caspase-3 mRNA and GDF-9 mRNA combined to predict IVF-ET clinical pregnancy was 0.891, which was larger than n FoxO1 mRNA alone (AUC=0.796, n P=0.012).n Conclusion:FoxO1 mRNA, n Caspase-3 mRNA, and GDF-9 levels are related to embryonic development and sex hormone levels. Increased expression of n FoxO1 mRNA and GDF-9 and decreased expression of n Caspase-3 mRNA are beneficial to clinical pregnancy. Combined detection of n FoxO1, n Caspase-3 and GDF-9 can evaluate IVF-ET clinical pregnancy.n