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目的探讨绝经前子宫肌瘤患者行子宫全切术后1年内卵巢功能的变化。方法选取2012年1月至2015年10月本院因子宫肌瘤分别行子宫全切术和肌瘤剔除术的年龄为45~50未停经的妇女45例和43例。分别于术前、术后1、6、12月抽取患者外周静脉血,测定血清抗苗勒氏管激素(AMH)、卵泡刺激素(FSH)、雌二醇(E2)和促黄体生成素(LH)的水平,比较这四项指标在手术后1年内的变化。结果子宫全切后,患者AMH水平自术后1月(1.16±0.23)μg/L开始呈现下降趋势(P<0.05),术后6月为(0.78±0.39)μg/L,术后12月为(0.71±0.27)μg/L,与术前(1.27±0.29)μg/L比较差异有统计学意义(P<0.05)。同时,子宫全切术后6月和术后12月,FSH由术前(7.78±3.29)m IU/ml上升至术后6月的(25.37±17.39)m IU/ml。E2由术前(103.29±12.77)pg/ml明显降低至术后6月的(95.64±16.198)pg/ml,比较差异有统计学意义(P<0.05)。LH则组间比较差异无统计学意义(P>0.05)。AMH、FSH、E2和LH在肌瘤剔除术组则无显著变化。结论绝经前妇女行子宫全切术后可能会加速卵巢衰老过程,而AMH灵敏度比FSH、E_2、LH更高。
Objective To investigate the changes of ovarian function in patients with premenopausal uterine fibroids within 1 year after hysterectomy. Methods Forty-five women and 45 women aged 45-50 without menopause underwent hysterectomy and myomectomy respectively from January 2012 to October 2015 in our hospital. Peripheral venous blood samples were taken from patients before surgery, from January to June and from December to December after operation respectively. Serum anti-Müllerian hormone (AMH), follicle stimulating hormone (FSH), estradiol (E2) and luteinizing hormone LH) levels, compare the four indicators in the postoperative change within 1 year. Results After hysterectomy, the AMH level decreased from 1.16 ± 0.23 μg / L at 1 month (P <0.05) to (0.78 ± 0.39) μg / L at 6 months after operation, and at 12 months (0.71 ± 0.27) μg / L, compared with preoperative (1.27 ± 0.29) μg / L, the difference was statistically significant (P <0.05). At the same time, the FSH increased from 7.78 ± 3.29 mIU / ml preoperatively to (25.37 ± 17.39) mIU / ml at 6 months and 6 months after hysterectomy. E2 decreased from 103.29 ± 12.77 pg / ml preoperatively to 95.64 ± 16.198 pg / ml postoperative June, with statistical significance (P <0.05). LH was no significant difference between groups was statistically significant (P> 0.05). AMH, FSH, E2 and LH in the myomectomy group did not change significantly. Conclusions Postmenopausal women may accelerate the process of ovarian aging after hysterectomy, but the sensitivity of AMH is higher than that of FSH, E_2 and LH.