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重度卵巢过度刺激综合征患者遗传性血栓形成倾向的患病率

Prevalence of inherited thrombophilia in patients with severe ovarian hyperstimulation syndrome.

作者信息

Machac Stepan, Lubusky Marek, Prochazka Martin, Streda Robert

机构信息

Dept. of Obstetrics and Gynecology, University Hospital, Olomouc, Czech Republic.

出版信息

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2006 Nov;150(2):289-92. doi: 10.5507/bp.2006.044.

Abstract

BACKGROUND AND OBJECTIVE

To determine the prevalence of markers of inherited thrombophilia in patients with severe form of ovarian hyperstimulation syndrome (OHSS) DESIGN AND METHODS: Blood samples were analysed for markers of thrombophilia (mutation of factor V - Leiden, mutation of methylentetrahydrofolat reductase (MTHFR) C677T and mutation of prothrombin G20210A). The study group consisted of women who had undergone controlled ovarian hyperstimulation for IVF complicated by severe OHSS (group A, n = 50). Results were compared with two controls groups - women who underwent ovarian hyperstimulation for IVF without developing OHSS (group B, n = 93) and healthy pregnant women with no history of infertility (group C, n = 196).

RESULTS

We have found 7 out of 50 patients from group A positive for Leiden mutation (heterozygous) 11 out of 93 from group B (heterozygous), p = 0.71 OR 1.21 (0.39 3.70) and 10 out of 196 from group C (heterozygous), p = 0.03 OR 3.03 (0.97 9.28). Polymorphism of MTHFR 677T gene was detected in 17 out of 50 patients (heterozygous) from group A, in 36 out of 93 patients from group B (35 heterozygous, 1 homozygous) and in 93 out of 196 patients from the group C (86 heterozygous, 7 homozygous) with no statistical significance.

CONCLUSIONS

We found an increased prevalence of factor V Leiden mutation in Czech infertile women. However carriers of Leiden mutation had no enhanced risk of development severe form of OHSS during stimulation.

摘要

背景与目的

确定重度卵巢过度刺激综合征(OHSS)患者遗传性易栓症标志物的患病率。

设计与方法

对血样进行易栓症标志物分析(凝血因子V - 莱顿突变、亚甲基四氢叶酸还原酶(MTHFR)C677T突变和凝血酶原G20210A突变)。研究组由因体外受精(IVF)接受控制性卵巢刺激并并发重度OHSS的女性组成(A组,n = 50)。将结果与两个对照组进行比较——因IVF接受卵巢刺激但未发生OHSS的女性(B组,n = 93)和无不孕史的健康孕妇(C组,n = 196)。

结果

我们发现A组50例患者中有7例莱顿突变呈阳性(杂合子),B组93例中有11例(杂合子),p = 0.71,比值比(OR)为1.21(0.39至3.70);C组196例中有10例(杂合子),p = 0.03,OR为3.03(0.97至9.28)。A组50例患者中有17例检测到MTHFR 677T基因多态性(杂合子),B组93例患者中有36例(35例杂合子,1例纯合子),C组196例患者中有93例(86例杂合子,7例纯合子),差异无统计学意义。

结论

我们发现捷克不孕女性中凝血因子V莱顿突变的患病率增加。然而,莱顿突变携带者在刺激过程中发生重度OHSS的风险并未增加。

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