卵泡液和血清中内分泌腺源血管内皮生长因子对卵巢过度刺激综合征的预测价值

目的评价卵泡液和血清内分泌腺源血管内皮生长因子(EG-VEGF)浓度水平对接受控制性超促排卵(COH)的体外受精-胚胎移植(IVF-ET)妇女并发卵巢过度刺激综合征(OHSS)的预测价值。方法本研究为单中心的回顾性病例对照研究。2008年10月至2009年2月因输卵管和(或)男性因素进行IVF/ICSI治疗,COH中呈中、重度卵巢反应的不育妇女74例,其中OHSS组14例,非OHSS组60例。采用酶联免疫吸附试验(ELISA)检测取卵日卵泡液和取卵后第2天血清的EG-VEGF、VEGF浓度。结果所有患者中,卵泡液EG-VEGF、卵泡液VEGF和血清EG-VEGF浓度均与人绒毛膜促性腺激素(hCG)日血清雌二醇(E_2)水平呈显著负相关(r=-0.630,P0.01;r=-0.559,P0.01;r=-0.478,P0.01),而与血清VEGF浓度无此相关性,卵泡液EG-VEGF和卵泡液VEGF浓度间呈显著正相关(r=-0.412,P0.01)。与非OHSS组相比,OHSS组的卵泡液EG-VEGF、卵泡液VEGF和血清EG-VEGF浓度均明显降低(P0.01,P0.01,P0.05),而血清VEGF浓度无显著差异。与轻度OHSS者相比,中度OHSS者的卵泡液EG-VEGF浓度显著降低(P0.01),而血清EG-VEGF、卵泡液VEGF和血清VEGF浓度均无显著差异。结论卵泡液和黄体早期血清EG-VEGF浓度与卵巢反应负相关并在OHSS发生者中明显下降,可用于预测OHSS的发生。与VEGF相比,EG-VEGF对OHSS的预测性更强,且卵泡液EG-VEGF浓度还能预测OHSS的严重程度。

The predictive value of endocrine gland-derived vascular endothelial growth factor concentrations in follicular fluid and serum for ovarian hyperstimulation syndrome

Objective：To explore the relationship between follicular gland-derived vascular endothelial growth factor （EG-VEGF） undergoing controlled ovarian hyperstimulation （COH）. fluid and serum concentrations of endocrine and serum estradiol （E2） levels in patients Methods： Follicular fluids were collected at oocyte retrieval and sera collected two days after oocyte retrieval from 74 patients undergoing COH. Of these patients, 14 were diagnozed ovarian hyperstimulation syndrome （OHSS）, 60 without OHSS. Enzyme-linked imrnunosorbent assay was employed to measure the concentrations of EG-VEGF and VEGF in follicular fluid and serum. Results： In all patients, follicular fluid EG-VEGF and VEGF levels were both negatively correlated with serum E2 levels on hCG day （r=-0. 630,P〈0.01 and r=-0. 559,P〈0.01, respectively） and positively correlated with each other （r=0. 412, P〈0.01）. Serum EG-VEGF levels were also negatively correlated with serum E2 levels on hCG day （r=-0. 478, P〈0.01）, while serum VEGF had so such correlation. Women in OHSS group had lower levels of follicular fluid EG VEGF and VEGF and lower levels of serum EG-VEGF than those in non-OHSS group （P〈0.01, P〈0.01 and P〈0.05, respectively）. Follicular fluid EG-VEGF levels in the patients with moderate OHSS were lower than those in the patients with mild OHSS （P〈0.01）. Conclusions： In women undergoing COH, the concentrations of follicular fluid EG-VEGF and VEGF and serum EG-VEGF in early luteal phase were correlated with ovarian response, and could be predicators of OHSS, among which EG-VEGF was more valuable.