血清炎症细胞因子与多囊卵巢综合征不孕症患者IVF-ET助孕妊娠结局的相关性分析

目的分析血清炎症细胞因子与多囊卵巢综合征(PCOS)不孕症患者体外受精-胚胎移植(IVF-ET)助孕妊娠结局的相关性。方法选取2016年6月-2018年3月就诊于银川市妇幼保健院行IVF-ET助孕的PCOS不孕症患者100例为研究组,同期行IVF-ET助孕的非PCOS不孕症患者100例为对照组。根据体质指数(BMI),将两组患者分别分为PCOS肥胖组(A组,50例)、PCOS非肥胖组(B组,50例)、非PCOS肥胖组(C组,50例)、非PCOS非肥胖组(D组,50例)。4组均采用短效长方案超促排卵,检测血清核因子-κB(NF-κB)、肿瘤坏死因子-α(TNF-α)、超敏C-反应蛋白(hs-CRP)及中性粒细胞/淋巴细胞比值(NLR),分析IVF-ET助孕妊娠结局。结果4组患者血清hs-CRP、NLR、TNF-α及NF-κB水平比较差异均有统计学意义(均P<0.05)。NF-κB是评估PCOS患者低度慢性炎症较敏感的指标,TNF-α次之。4组患者卵子成熟率、受精率、优胚率、临床妊娠率、胚胎种植率、早期流产率比较差异均有统计学意义(均P<0.05)。Pearson相关性分析结果表明:血清NF-κB水平与PCOS不孕症患者卵子成熟率、受精率、临床妊娠率、胚胎种植率均显著相关(P<0.05)。结论PCOS患者体内慢性炎症反应可能通过胰岛素抵抗导致卵子质量及子宫内膜容受性下降,进而对患者的妊娠结局造成不良影响。

Analysis on the correlation between serum inflammatory factors and pregnancy outcome of IVF-ET in patients with polycystic ovary syndrome

Objective To analyze the correlation between serum inflammatory factors and pregnancy outcome of in vitro fertilizationembryo transfer(IVF-ET)in patients with polycystic ovary syndrome(PCOS).Methods From June 2016 to March 2018,100 infertile patients with PCOS treated by IVF-ET in Maternal and Child Health Care Hospital of Yinchuan City were selected as study group,100 infertile patients without PCOS treated by IVF-ET were selected as control group.According to body mass index(BMI),the patients in the two groups were divided into PCOS obesity group(A group,50 patients),PCOS non-obesity group(B group,50 patients),non-PCOS obesity group(C group,50 patients),non-PCOS non-obesity group(D group,50 patients).The patients in the four groups were given short acting long protocol.The levels of serum nuclear factorκB(NF-κB),tumor necrosis factor-α(TNF-α),high-sensitive C-reactive protein(hs-CRP),neutrophil/lymphocyte ratio(NLR)were detected.The pregnancy outcomes of IVF-ET were analyzed.Results There were statistically significant differences in the levels of serum hs-CRP,NLR,TNF-α,and NF-κB among the four groups(P<0.05).NF-κB was the sensitive indicator in predicting low-grade chronic inflammation of PCOS patients,followed by TNF-α.The fertilization rate,embryo implantation rate,and clinical pregnancy rate in A group were statistically significantly lower than those in B group,C group,and D group(P<0.05).The fertilization rate,embryo implantation rate,and clinical pregnancy rate in B group were statistically significantly lower than those in C group and D group(P<0.05).Oocyte maturation rate and high-quality embryo rate in C group were statistically significantly higher than those in A group and B group(P<0.05).Oocyte maturation rate and high-quality embryo rate in D group were statistically significantly higher than those in A group and B group(P<0.05).Early abortion rate in A group was statistically significantly higher than those in C group and D group(P<0.05).Early abortion rate in B group was statistically significantly higher than that in D group(P<0.05).Pearson correlation analysis showed that NF-κB was significantly correlated with oocyte maturation rate,fertilization rate,clinical pregnancy rate,and embryo implantation rate(P<0.05).Conclusion The chronic inflammatory reaction has adverse impact on pregnancy outcome of PCOS patients by reducing oocytes quality and endometrial receptivity due to insulin resistance.