Kasum Miro, Oresković Slavko
University Department of Obstetrics and Gynecology, School of Medicine, University of Zagreb, Croatia.
Acta Clin Croat. 2011 Jun;50(2):281-8.
Ovarian hyperstimulation syndrome is the most dangerous complication following the administration of gonadotropins. There is no preventive and pharmacological intervention that can fully prevent development of this syndrome. The best strategy to reduce the incidence of the condition is to identify the patients at risk before ovarian stimulation and to recognize potential predictors. A history of ovarian hyperstimulation is an important risk factor for recurrence of the syndrome. The risk of the syndrome is evident with elevated gonadotropin dosages and with the use of gonadotropin releasing hormone agonists. Human chorionic gonadotropin is the main risk factor. The combination of pretreatment diagnosis of polycystic ovary disease and estradiol of 4500 pg/ mL gives higher prediction rates for the risk factor. Serum concentration of inhibin is not a reliable predictor of the syndrome. Recent evaluation of antimüllerian hormone as a reliable predictor candidate, vascular endothelial growth factor with cadherin as indicators of vascular permeability, and detection of mutations in the follicular stimulating hormone receptor as predictors of severity offer new insights in the prognosis of the syndrome. Identification of these prognostic markers in patients at risk would be very useful for prevention of the syndrome prior to the appearance of symptoms.
卵巢过度刺激综合征是使用促性腺激素后最危险的并发症。目前尚无能够完全预防该综合征发生的预防性和药物干预措施。降低该病症发生率的最佳策略是在卵巢刺激前识别出有风险的患者，并识别潜在的预测因素。卵巢过度刺激病史是该综合征复发的重要危险因素。随着促性腺激素剂量的增加以及促性腺激素释放激素激动剂的使用，该综合征的风险明显增加。人绒毛膜促性腺激素是主要危险因素。多囊卵巢疾病的预处理诊断与雌二醇水平为4500 pg/mL相结合，对危险因素的预测率更高。抑制素的血清浓度不是该综合征的可靠预测指标。最近将抗苗勒管激素评估为可靠的预测指标候选物、将血管内皮生长因子与钙黏蛋白作为血管通透性指标以及检测促卵泡激素受体突变作为严重程度预测指标，为该综合征的预后提供了新的见解。在有风险的患者中识别这些预后标志物对于在症状出现之前预防该综合征非常有用。
