CAJ | 학술논문

目的：探讨卵巢早衰（POF）性不孕症的发病相关因素、预后及其对妊娠结局的影响。方法：以42例卵巢早衰性不孕症为研究对象（POF 组），收集同期输卵管性不孕症患者60例作为对照（对照组），分析 POF 发病相关因素、临床预后以及受孕和妊娠结局情况。结果：POF 组全部都有停经史，平均孕产次低于对照组（P ＜0.001），但是初潮平均年龄两组相当（P ＞0.05）。POF 组 FSH、LH 和 E 激素水平，子宫、双侧卵巢体积以及窦卵泡计数等与对照组明显不同（P ＜0.001）。POF 组患者中腮腺炎病毒／细菌感染史、宫颈Leep 刀手术史、放射性及有毒物质长期接触史以及自身免疫性疾病史的构成比显著高于对照组（P ＜0.001），但是附件手术史以及巨大精神创伤史两组间差异无统计学意义（P ＞0.05）。POF 组治疗1年后月经周期恢复率及自觉症状改善率均在95％以上，激素 FSH、E、LH，子宫体积、卵巢体积、窦卵泡等情况也在持续改善，但是，卵巢功能相关临床指标达标率较低。两组随访2年，POF 组自然妊娠率7.4％（3／42），辅助生殖率4.8％，抱婴率4.8％（2／42），对照组自然妊娠率25.0％（15／60），辅助生殖率28.3％，抱婴率38.3％（23／60），两组自然妊娠率、辅助生殖率以及抱婴率差异有统计学意义（P ＜0.05）。结论：卵巢早衰性不孕症发病病因复杂，可能和多种因素有关，治疗效果不佳，卵巢功能指标恢复正常率较低，治疗后妊娠率、抱婴率也较低，要加强预防，早诊断、早治疗。
목적：탐토란소조쇠（POF）성불잉증적발병상관인소、예후급기대임신결국적영향。방법：이42례란소조쇠성불잉증위연구대상（POF 조），수집동기수란관성불잉증환자60례작위대조（대조조），분석 POF 발병상관인소、림상예후이급수잉화임신결국정황。결과：POF 조전부도유정경사，평균잉산차저우대조조（P ＜0.001），단시초조평균년령량조상당（P ＞0.05）。POF 조 FSH、LH 화 E 격소수평，자궁、쌍측란소체적이급두란포계수등여대조조명현불동（P ＜0.001）。POF 조환자중시선염병독／세균감염사、궁경Leep 도수술사、방사성급유독물질장기접촉사이급자신면역성질병사적구성비현저고우대조조（P ＜0.001），단시부건수술사이급거대정신창상사량조간차이무통계학의의（P ＞0.05）。POF 조치료1년후월경주기회복솔급자각증상개선솔균재95％이상，격소 FSH、E、LH，자궁체적、란소체적、두란포등정황야재지속개선，단시，란소공능상관림상지표체표솔교저。량조수방2년，POF 조자연임신솔7.4％（3／42），보조생식솔4.8％，포영솔4.8％（2／42），대조조자연임신솔25.0％（15／60），보조생식솔28.3％，포영솔38.3％（23／60），량조자연임신솔、보조생식솔이급포영솔차이유통계학의의（P ＜0.05）。결론：란소조쇠성불잉증발병병인복잡，가능화다충인소유관，치료효과불가，란소공능지표회복정상솔교저，치료후임신솔、포영솔야교저，요가강예방，조진단、조치료。
Objectives:To investigate the related etiology factors,prognosis and the effect on pregnancy for infertility patients with premature ovarian failure (POF).Methods:42 infertility patients with POF were selected as study objects (POF group),and 60 patients with tubal infertility were collected as control (control group).The re-lated pathogenesis factors,clinical prognosis and pregnancy outcome of two groups was analyzed.Results:In POF group,all patients had menopause history,with fewer gravidity number on average than the control group (P <0.001);however,the age of menarche between two groups was roughly same (P >0.05).In POF group,the hor-mone levels of FSH,LH and E,the volume of uterine and bilateral ovarian,and the count of antral follicle was sig-nificantly different from those in the control group (P <0.001).The constitute ratio of patients with mumps virus/bacteria infection history,cervical Leep knife operation history,radioactive and toxic substances long -term contact history and autoimmune disease history in POF group was significantly higher than that of control group (P <0.001),but the attachment operation history and tremendous mental trauma between two groups had no significant difference (P >0.05).After 1 years of treatment,both menstrual cycle recovery rate and self -conscious symptom improvement rate in POF group were over 95%,while FSH,E,LH,volume of uterus and ovarian,antral follicle also improved continually,however,the compliance rate of clinical indicators on ovarian function was still low.Two groups were followed up for 2 years.The natural pregnancy rate of POF group was 7.4% (3 /42)with 4.8% assis-ted reproductive rate and 4.8% carried infant rate;while in control group,the natural pregnancy rate was 25%(15 /60),assisted reproductive rate was 28.3%,with 38.3%(23 /60)carried infant rate;the difference in natural pregnancy rate,assisted reproductive rate and carried infant rate between the two groups was statistically significant (P <0.05).Conclusion:The etiology of infertility with premature ovarian failure is complex,relevant to various factors.The treatment effect is poor,with low recovery rate of ovarian function,and the pregnancy rate and carried infant rate after treatment is also low.Therefore,it is important to strengthen prevention,early diagnosis and early treatment for POF.