甲状腺自身免疫性抗体与不孕女性卵巢储备功能的关联性研究

卜晓萌; 刘艳君; 张巧利; 贾婵维; 马延敏; 李莘

doi:10.16016/j.2097-0927.202405115

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甲状腺自身免疫性抗体与不孕女性卵巢储备功能的关联性研究

临床医学 | 更新时间：2026-01-09

- 甲状腺自身免疫性抗体与不孕女性卵巢储备功能的关联性研究
- Association between thyroid-associated antibodies and ovarian reserve in infertile women: a clinical study of 526 cases
- 陆军军医大学学报 2024年46卷第20期页码：2330-2336
- 作者机构：
  
  1.100026 北京，首都医科大学附属北京妇产医院生殖医学科
  2.100026 北京，北京妇幼保健院生殖医学科
  3.100096 北京，解放军总医院京北医疗区麻醉科
- 作者简介：
  
  [李莘，E-mail: 961213722@qq.com LI Xin, E-mail: 961213722@qq.com
- 基金信息：
  
  妇幼健康基金会基金项目(2022AMCHS002)
- DOI：10.16016/j.2097-0927.202405115
  中图分类号： R343.23;R730.23;R737.25
- 收稿：2024-05-30，
  
  修回：2024-07-14，
  
  纸质出版：2024-10-30
- 稿件说明：
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卜晓萌, 刘艳君, 张巧利, 等. 甲状腺自身免疫性抗体与不孕女性卵巢储备功能的关联性研究[J]. 陆军军医大学学报, 2024,46(20):2330-2336.

Xiaomeng BU, Yanjun LIU, Qiaoli ZHANG, et al. Association between thyroid-associated antibodies and ovarian reserve in infertile women: a clinical study of 526 cases[J]. Journal of Army Medical University, 2024, 46(20): 2330-2336.
卜晓萌, 刘艳君, 张巧利, 等. 甲状腺自身免疫性抗体与不孕女性卵巢储备功能的关联性研究[J]. 陆军军医大学学报, 2024,46(20):2330-2336. DOI： 10.16016/j.2097-0927.202405115.

Xiaomeng BU, Yanjun LIU, Qiaoli ZHANG, et al. Association between thyroid-associated antibodies and ovarian reserve in infertile women: a clinical study of 526 cases[J]. Journal of Army Medical University, 2024, 46(20): 2330-2336. DOI： 10.16016/j.2097-0927.202405115.

摘要

目的

比较不同卵巢储备功能不孕女性甲状腺自身免疫性抗体阳性率的差异，寻找与卵巢储备功能减退的相关免疫因素。

方法

采用病例-对照研究设计方案，收集2020年6-12月在北京妇产科医院生殖医学科就诊的不孕患者，检测纳入的526例不孕患者抗苗勒氏管激素(anti-Müllerian hormone，AMH)、促甲状腺素(thyroid stimulating hormone，TSH)、甲状腺球蛋白抗体(thyroglobulin antibody，TGAb)和甲状腺过氧化物酶抗体(thyroid peroxidase antibody，TPOAb)；根据AMH水平(>1.1 ng/mL和≤1.1 ng/mL)，将患者分为卵巢储备正常组和卵巢储备减退组，并进行年龄分层(25~30岁，>30~35岁

>35~40岁)，比较不同卵巢储备患者的TSH、TGAb和TPOAb的差别，分析卵巢储备功能减退降低的关联因素。

结果

在单因素分析中显示卵巢储备减退组患者的TPOAb(18.8%

11.1%，

=0.024)和TGAb(18.8%

8.0%，

=0.001)阳性率较高，存在显著性差异。多因素Logistic回归分析提示年龄、TGAb阳性和卵巢储备减退有关联[

=1.083(95%

: 1.021~1.150)，

=0.008;

=1.159(95%

: 1.034~1.301)

=0.011

]

。亚组分析显示，在

35~40岁年龄组中，TGAb阳性及TPOAb阳性与AMH分组的存在显著相关性(

＜0.05)。

结论

卵巢储备功能减退的不孕女性TGAb和TPOAb较高，>35~40岁不孕女性的卵巢储备功能减退可能与TGAb及TPOAb阳性相关。

Abstract

Objective

To compare the positive rate of thyroid autoantibodies in infertile women with different ovarian reserve function

and investigate the immune factors of diminished ovarian reserve.

Methods

A cross-sectional study was conducted on infertile women admitted to Department of Reproductive Medicine of Beijing Gynaecology and Obstetrics Hospital from June to December

2020. The levels of anti-Müllerian hormone (AMH)

thyroid stimulating hormone (TSH)

thyroglobulin antibody (TGAb) and thyroid peroxidase antibody (TPOAb) were detected in the 526 enrolled infertile patients. According to their AMH level

they were divided into normal ovarian reserve group and diminished ovarian reserve group. After they were stratified according to their age

the differences of TSH

TGAb and TPOAb levels were compared in the different age groups to analyze the related factors for diminished ovarian reserve.

Results

Univariate analysis showed that the diminished ovarian reserve group had significantly higher positive rates of TPOAb (18.8%

11.1%

=0.024) and TGAb (18.8%

8.0%

=0.001) than the normal ovarian reserve group. Multivariate logistic regression analysis indicated that age and TGAb positivity were related to diminished ovarian reserve [

=1.083(95%

: 1.021~1.150)

=0.008;

=1.159(95%

: 1.034~1.301)

=0.011

]

. Subgroup analysis suggested that the positive TGAb and TPOAb were significantly correlated with AMH level in the 36-~40-year-old group (

0.05).

Conclusion

The infertile women with diminished ovarian reserve have higher TGAb and TPOAb levels

and the diminishment in those aged 36~40 years might be related to the positive TGAb and TPOAb.

关键词

Keywords

references

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