腹腔镜下卵巢囊肿剥除术前后AMH和bFSH水平的变化及其临床意义

目的：观察腹腔镜下卵巢囊肿摘除术后患者抗穆勒氏管激素(AMH)和基础卵泡激素(bFSH)水平和卵巢功能的变化，并探讨其临床意义。方法选择2013年9月至2015年7月我院妇科接诊的154例卵巢囊肿患者，均采用腹腔镜下卵巢囊肿剥除术治疗，依据病理结果将患者分为巧克力囊肿组(n=75)和非巧克力囊肿组(n=79)，比较两组患者手术前后的AMH和bFSH水平。选取单侧囊肿患者，手术6个月后行超声检查，记录患侧与健侧卵巢体积(VO)、卵巢间质动脉收缩期峰值(PSV)和窦卵泡素(AFC)。结果巧克力囊肿组和非巧克力囊肿组患者术后AMH水平均较术前明显下降，且巧克力囊肿组患者AMH水平下降幅度大于非巧克力囊肿组，差异均有统计学意义(P<0.05)；巧克力囊肿组患者术后bFSH水平显著高于术前，差异具有统计学意义(P<0.05)，而非巧克力囊肿组患者术后bFSH水平与术前比较差异无统计学意义(P>0.05)；单侧囊肿患者在术后6个月的超声检查中，囊肿剥除术侧与正常侧在VO、PSV和AFC方面比较差异均无统计学意义（P>0.05）。结论腹腔镜下卵巢囊肿摘除术后患者AMH水平有大幅度下降，且下降幅度与病理类型关系密切，AMH是评价卵巢功能的可选指标，卵巢功能在术后6个月基本恢复正常。

Changes and clinical significance of AMH and bFSH levels before and after laparoscopic removal of ovarian cyst

Objective To observe the changes and clinical significance of anti-Mullerian hormone (AMH) and bovine follicle-stimulating hormone (bFSH) levels before and after laparoscopic removal of ovarian cyst. Methods A total of 154 cases of ovarian cyst patients, who admitted to Department of Gynecology of Songgang People's Hospital of Baoan District of Shenzhen and underwent laparoscopic ovarian cystectomy treatment from September 2013 to July 2015, were selected and divided into the chocolate cyst group (n=75) and the non-chocolate cyst group (n=79) according to pathological results. The AMH and bFSH levels of the two groups were compared before and after surgery. The contra-lateral ovary volume (VO), peak systolic velocity (PSV) and antral follicle count (AFC) were recorded by ultrasonogra-phy after 6 months of operation in patients with unilateral cyst. Results The AMH levels in the two groups were signifi-cantly lower than those before operation, and the decrease of AMH level in the chocolate cyst group was greater than that of the non-chocolate cyst group (P<0.05);the bFSH level of the chocolate cyst group after operation was significant-ly higher than that before operation (P<0.05), while there was no significant difference in the bFSH level of non-choco-late cyst group before and after operation (P>0.05). In the ultrasonography examination of patients with unilateral cysts at 6 months after operation, there were no differences between cystectomy side and normal side in VO, PSV and AFC (P>0.05). Conclusion The postoperative level of AMH in laparoscopic enucleation of ovarian cyst patients is signifi-cantly decreased, and the decrease is closely related to pathological type. AMH is an optional index to evaluate ovarian function, and the ovarian function returned to normal 6 months after operation.