女性围绝经期不同阶段血清抑制素B的变化及临床意义

Changes of serum inhibin B levels in different perimenopausal stages and its clinical significance

关键词:  围绝经期  抑制素B  卵巢功能衰退  月经周期

Key words:  perimenopausal  inhibinB  Ovarian function decline  Menstrual cycle

摘要:

目的分析围绝经期妇女不同阶段血清抑制素B(inhibin B, INH_B)水平的变化及其临床意义。方法选择2010年3月至2012年7月黄浦区中心医院妇科门诊患者及健康普查妇女118例，年龄45 ~53岁，按月经周期分4组：对照组30例，月经周期规则；围绝经早期组30例，闭经3 ~6个月；围绝经晚期组28例，闭经7 ~12个月；绝经后期组30例，闭经13 ~36个月。分别用酶联免疫吸附试验检测血清INHB,放射免疫法检测血清雌二醇（estradiol, E₂)、促印泡素（follicle-stimulating hormone, FSH)水平，分析各组激素水平变化之间的关系。结果与对照组相比，INHb于围绝经早期就明显下降（r=2.79，P<0.01),但FSH、E₂于围绝经早期无明显变化（P>0.05);而FSH明显上升（t=7.67,P<0.001)与E₂的明显下降=6.43,P<0.001)都发生在围绝经晚期，而此阶段INH_B也有进一步下降但差异无统计学意义（P>0.05)。绝经后期与围绝经晚期比较INH_B进一步下降（t=2.68, P<0.01)、FSH进一步上升（t=3.41, P<0.01)、E₂进一步下降（t=3.39,P<0.01)。研究还显示，INH_B的变化与FSH呈负相关（r=-0.423,P<0.01)、与E₂呈正相关（r=0.407,P<0.01)。结论血清INH_B的下降是围绝经期最早变化的生化指标，可预判卵巢功能衰退和围绝经期起点。

Abstract:

Objective To investigate changes of serum inhibin B (INHB ) levels in different perimenopausal stages and its clinical significance. Methods One hundred and eighteen women aged 45?53，who visited gynecology clinic for consultation or health check from March 2010 to July 2012, were enrolled in the study. All subjects were divided into four groups according to the menstrual cycle:control group (n=30) with regular menstrual cycles，early perimenopausal group (n=30)，late perimenopausal group(n=28) and postmenopausal group(n=30). Serum inhibin(INH_B) levels were detected by enzyme-linked immunosorbent assay ( ELISA);serum estradiol ( E₂) and follicle-stimulating hormone ( FSH) levels were detected by radioimmunoassay. Results Compared to controls, INH_B levels in early perimenopause were decreased(t=2.79,P<0.01)，but no significant changes in serum FSH and E₂(P>0.05). A significant increase in FSH (t=1.61, P<0.001) and decline in E₂(r=6.43, P<0.001) were detected in late perimenopause, while INH_B presented a tendency of decline but not significantly. Compared to late perimenopause, INH_B levels in postmenopause were declined(r=2.68, P<0.01), FSH further increased(t=3.41，P<0.01) and E₂ further declined (t=3.39, P<0.01). The INH_B changes were negatively correlated with FSH levels(r=-0.423，P<0.01) and positively correlated with E₂ levels (r=0.407，P<0.01). Conclusion Serum INR_B level in perimenopausal women may be used as a biochemical marker for predicting ovarian failure and menopause.