CAJ | 학술논문

目的：探讨影响腹腔镜卵巢打孔治疗多囊卵巢综合征（PCOS）不孕患者自然妊娠的相关因素。方法以腹腔镜卵巢打孔治疗 PCOS 后自然妊娠患者168例为妊娠组，未能自然妊娠患者82例为未妊娠组，对比分析两组患者一般情况、打孔数目、术后并发盆腔粘连、患者卵巢储备功能及激素分泌情况。结果妊娠组 BMI≥23 kg/ m2者所占比例（48.2%）显著低于未妊娠组（68.3%）（χ2=8.968，P <0.01）。两组打孔数目相比无显著差异（3.2±1.6 vs 3.5±1.8）（t =1.3351，P >0.05）。妊娠组术后并发盆腔粘连（1.8%）较非妊娠组（9.8%）显著降低（χ2=8.3221，P <0.01）。妊娠组术后卵巢体积（OV）、窦卵泡数（AFC）、基础黄体生成素（LH）、卵泡雌激素（FSH）、雌二醇（E2）及性激素结合球蛋白（SHBG）均显著高于非妊娠组（P <0.05或 P <0.01），基础睾酮（T）、雄激素游离指数（FAI）、稳态胰岛素评价指数（HOMA-IR）均较非妊娠组显著降低（P <0.01）。结论 BMI、卵巢储备功能、高雄激素血症及胰岛素抵抗与 PCOS 患者卵巢打孔治疗后自然妊娠相关。
목적：탐토영향복강경란소타공치료다낭란소종합정（PCOS）불잉환자자연임신적상관인소。방법이복강경란소타공치료 PCOS 후자연임신환자168례위임신조，미능자연임신환자82례위미임신조，대비분석량조환자일반정황、타공수목、술후병발분강점련、환자란소저비공능급격소분비정황。결과임신조 BMI≥23 kg/ m2자소점비례（48.2%）현저저우미임신조（68.3%）（χ2=8.968，P <0.01）。량조타공수목상비무현저차이（3.2±1.6 vs 3.5±1.8）（t =1.3351，P >0.05）。임신조술후병발분강점련（1.8%）교비임신조（9.8%）현저강저（χ2=8.3221，P <0.01）。임신조술후란소체적（OV）、두란포수（AFC）、기출황체생성소（LH）、란포자격소（FSH）、자이순（E2）급성격소결합구단백（SHBG）균현저고우비임신조（P <0.05혹 P <0.01），기출고동（T）、웅격소유리지수（FAI）、은태이도소평개지수（HOMA-IR）균교비임신조현저강저（P <0.01）。결론 BMI、란소저비공능、고웅격소혈증급이도소저항여 PCOS 환자란소타공치료후자연임신상관。
Objective To explore the factors correlated with natural pregnancy of patients with polycystic ovary syndrome (PCOS)after laparoscopic ovarian drilling( LOD). Methods Total 168 pregnant patients with PCOS after LOD treatment were considered as the pregnancy group,and 82 non-pregnant patients were considered as the non-pregnancy group. The general conditions, amount of drillings,complicated pelvic adhesions after operation,and the reserved ovarian function and hormone secretion level were compared between the 2 groups. Results The ratio of patients whose BMI≥23 kg/ m2 in the pregnancy group(48. 2% )was obviously lower than that in the non-pregnancy group(68. 3% )(χ2 = 8. 968,P < 0. 01). The amounts of drillings had not obvious difference (3. 2 ± 1. 6 vs 3. 5 ± 1. 8)between the 2 groups( t = 1. 3351,P > 0. 05);the incidence of the complicated pelvic adhesions in the pregnancy group(1. 8% )was obviously lower than that in the non-pregnancy group(9. 8% ,χ2 = 8. 3221,P < 0. 01);OV,AFC,basal levels of LH,FSH,E2 and SHBG of patients in the pregnancy group were obviously higher than those in the non-pregnancy group(P <0. 05 or P < 0. 01);and T,FAI and HOMA-IR of patients in the pregnancy group were obviously lower than those in the non-pregnancy group(P < 0. 01). Conclusion The BMI,reserved ovarian function,hyper-androgenemia(HA)and insulin resistance are related to natural pregnancy of patients with POCS after laparoscopic ovarian drilling.