卵巢子宫内膜异位囊肿患者血清中抗苗勒管激素水平的临床分析

Clinical Analysis of Anti-Mullerian Hormone Levels in Serum of Patients with Ovarian En-dometriosis Cysts

摘要: 目的：探讨卵巢子宫内膜异位症(Endometrioma, OMA)患者血清中AMH水平与其临床特征及囊肿大小之间的关系。方法：收集2012年1月至2021年10月在青岛大学附属医院的132例OMA患者作为研究组，136例非巧囊卵巢良性囊肿患者作为对照组，比较两组间基线资料差异，分析年龄、生育状况、囊肿偏侧性，尤其是囊肿大小对OMA患者血清中AMH水平的影响。结果：1) 分层分析得出，OMA及非OMA组的术前AMH水平在囊肿偏侧性上均无差别；除OMA直径 > 12 cm亚组外，各亚组间术前血清AMH平均浓度随囊肿的增大而增加且有统计学意义(P < 0.001)，而在对照组中，各亚组间血清AMH水平无明显差异(P = 0.057)；2) 单因素分析提示OMA患者血清中AMH水平与囊肿大小、年龄及生育状况有关，差异均有统计学意义(P < 0.05)；3) 多元线性回归分析提示，血清AMH水平与囊肿体积之间的正线性关系具有统计学意义(P = 0.00002)。结论：血清AMH水平往往与卵巢子宫内膜异位囊肿大小呈正线性相关，应在临床中更加全面的评估卵巢储备。

Abstract: AIM: To discuss the relationship between serum levels of AMH in patients with ovarian endometrio-sis and their clinical characteristics and cyst size. METHODS: 132 patients with OMA hospitalized at the Affiliated Hospital of Qingdao University from January 2012 to October 2021 were collected as the study group, and 136 patients with non-coarctation benign ovarian cysts were used as the con-trol group to compare the differences in baseline data between the two groups and to analyze the effects of age, fertility status, cyst laterality, and especially cyst size on serum AMH levels in patients with OMA. RESULTS: 1) Stratified analysis yielded no difference in preoperative AMH levels be-tween OMA and non-OMA groups in terms of cyst laterality; except for the OMA diameter > 12 cm subgroup, the mean preoperative serum AMH concentration increased with increasing cysts and was statistically significant among subgroups (P < 0.001), whereas in the control group, there was no significant difference in serum AMH levels among subgroups (P = 0.057); 2) Univariate analysis suggested that serum AMH levels in OMA patients were related to cyst size, age and fertility status, with statistically significant differences (P < 0.05); 3) Multiple linear regression analysis suggested that the positive linear relationship between serum AMH levels and cyst volume was statistically significant (P = 0.00002). CONCLUSION: Serum AMH levels tend to be positively and linearly corre-lated with ovarian endometriosis cyst size, and ovarian reserve should be more comprehensively assessed in clinical practice.