난소 자궁내막증의 수술적 치료를 받은 여성의 혈중 항뮬러관 호르몬 연구
Serum anti-Müllerian hormone levels in the patients with ovarian endometriosis undergoing surgical treatment
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목적난소 자궁내막증으로 인해 수술적 치료를 받은 여성군의 혈중 anti-Müllerian hormone (AMH)를 대조군과 비교 분석하고자 하였다. 연구방법2010년 3월부터 2011년 1월까지 본원에서 AMH를 검사 받은 26-40세의 여성 환자 217명을 대상으로 후향적으로 연구하였다. 그 중 난소 자궁내막증으로 난소 낭종제거술을 시행받았던 연구군은 105명이었고, 과거의 난소종양이나 기타 다른 부인과 수술 병력이 없는 대조군은 112명이었다. 생리불순, 다낭성 난소증후군, 체질량지수 ＞30 kg/m2, 다른 내분비 질환을 가진 환자는 연구대상에서 제외되었다. 결과평균 연령은 연구군과 대조군간 차이는 없었으나(32.5±3.6세 vs. 33.0 ± 3.8세), 혈중 AMH는 연구군이 대조군에 비해 통계적으로 유의하게 낮았다(2.82 ± 2.4 ng/mL vs. 3.83 ± 2.8 ng/mL; P = 0.005). 연령군에 따라 분류하였을 때, 31세 이상의 연구군에서 혈중 AMH가 유의하게 더 낮음을 알 수 있었다(31-35세, 2.41±1.7 vs. 3.84 ± 2.6 ng/mL, P = 0.005; 36-40세, 1.36 ± 2.0 ng/mL vs. 2.68 ± 2.7 ng/mL,P = 0.018). 그러나 난소 자궁내막증의 양측성, 낭종의 크기(6 cm 기준), 자궁내막증 병기에 따른 혈중 AMH의 차이는 없었다. 결론난소 자궁내막증으로 수술적 치료를 받은 환자는 같은 연령대의 수술 받지 않은 정상 여성보다 혈중 AMH가 낮음을 고려해야 한다.
Abstract
Objective To evaluate the difference of serumanti-Müllerian hormone (AMH) levels in women between undergoing previous ovarian surgery with endometriosis and controls. Methods We reviewed medical records and evaluated the serum AMH levels of 217 women (26−40 years old) between March 2010 and January 2011, retrospectively. One hundred five patients were previously undergone the ovarian surgery of endometriosis (study group) and 112 women has never undergone ovarian surgery as controls (control group). Exclusion criteria was following factors: irregular menstruation, polycystic ovary syndrome, high BMI (≥30 kg/m2), other endocrine disease. Results The mean age in study group was not different with control group (32.5±3.6 vs. 33.0 ± 3.8 year). The mean serum AMH levels significantly lower in the study group than in control (2.82 ± 2.4 ng/mL vs. 3.82 ± 2.8 ng/mL, P=0.005). When we analyzed the serum AMH levels according to age groups, the patients above 31 years showed significantly lower levels than control (31−35 years, 2.41±1.7 ng/mL vs. 3.84 ± 2.6 ng/mL, P=0.005; 36−40 years, 1.36 ± 2.0 ng/mL vs. 2.68±2.7 ng/mL, P=0.018) The serum AMH levels didn’t show any statistical difference in aspect of bilaterality, endometriosis stage, cyst size (≥6 cm). Conclusion We could consider relatively low serum AMH levels in patients with ovarian endometriosis after surgical treatment.
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