Daya S, Ward S, Burrows E
Department of Obstetrics and Gynaecology, McMaster University, Hamilton, Ontario, Canada.
Am J Obstet Gynecol. 1988 Feb;158(2):225-32. doi: 10.1016/0002-9378(88)90127-5.
The existence of luteal phase defect has been the focus of much debate, mainly because of inconsistencies in its diagnosis and management. This study was performed to compare progesterone profiles in women with luteal phase defect with those of women with normal cycles and to establish a discriminatory level of serum progesterone that may aid in the diagnosis of this condition. Compared with patients with luteal phase defect cycles, women with normal cycles produced significantly more progesterone in the luteal phase. The serum progesterone level (less than or equal to 21 nmol/L) was the optimal discriminatory level between luteal phase defect and normal cycles and provided a diagnostic test with 70% sensitivity and 71% specificity. In women with recurrent abortion, the incidence of luteal phase defect was 40%, but with treatment 81% of pregnancies were successful. The findings in this study support the existence of luteal phase defect as a clinically significant entity in recurrent first-trimester spontaneous abortion and one that can be treated successfully with the administration of progesterone. The histologic diagnosis of luteal phase defect may also be confirmed with serum progesterone.
黄体期缺陷的存在一直是诸多争论的焦点，主要是因为其诊断和处理存在不一致性。本研究旨在比较黄体期缺陷女性与月经周期正常女性的孕酮水平，并确定有助于诊断该病症的血清孕酮鉴别水平。与黄体期缺陷周期的患者相比，月经周期正常的女性在黄体期产生的孕酮明显更多。血清孕酮水平（小于或等于21 nmol/L）是黄体期缺陷与正常周期之间的最佳鉴别水平，该诊断试验的敏感性为70%，特异性为71%。在复发性流产的女性中，黄体期缺陷的发生率为40%，但经过治疗后，81%的妊娠获得成功。本研究结果支持黄体期缺陷作为孕早期复发性自然流产中具有临床意义的实体存在，且通过给予孕酮可成功治疗。黄体期缺陷的组织学诊断也可通过血清孕酮得到证实。
