EFI评分、血清MMIF、YKL-40与子宫内膜异位症患者卵巢功能、临床分期的关系

摘要 目的：探讨生育指数（EFI）评分、血清巨噬细胞移动抑制因子（MMIF）、甲壳质酶蛋白 40（YKL-40）与子宫内膜异位症患者卵巢功能、临床分期的关系。方法：选取我院2020年6月到2023年6月收治的80例子宫内膜异位症患者，分为观察组，另选取同期来我院体检的80名健康女性志愿者作为对照组。对比两组受检者EFI评分、血清MMIF、YKL-40及卵巢功能指标表达水平。应用美国生殖医学协会子宫内膜异位症分期标准(r-AFS)对80例子宫内膜异位症患者进行分期，其中Ⅰ期15例，Ⅱ期23例，Ⅲ期25例，Ⅳ期17例，对比不同r-AFS分期患者EFI评分、血清MMIF、YKL-40表达水平。并采用Spearman相关法分析法分析EFI评分、血清MMIF、YKL-40与卵巢功能指标的相关性。结果：观察组患者EFI评分低于对照组，血清MMIF、YKL-40表达水平高于对照组（P＜0.05）；观察组抗苗勒氏管激素（AMH）、黄体生成素（LH）、卵泡刺激素（FSH）表达水平低于对照组，雌二醇（Estradiol，E₂）水平高于对照组（P＜0.05）；不同分期子宫内膜异位症患者EFI评分由高到低分别为Ⅰ期、Ⅱ期、Ⅲ期、Ⅳ期，MMIF和YKL-40水平由高到低分别为Ⅳ期、Ⅲ期、Ⅱ期、Ⅰ期，不同分期EFI评分、血清MMIF、YKL-40表达水平对比差异显著（P＜0.05）；Spearman相关法分析结果表明：EFI评分与AMH、LH、FSH呈正相关，与E2呈负相关（P＜0.05），MMIF和YKL-40与AMH、LH、FSH呈负相关，与E₂呈正相关（P＜0.05）。结论：EFI评分、血清MMIF、YKL-40水平与子宫内膜异位症患者的卵巢具有明显相关性，且不同子宫内膜异位症患者EFI评分、血清MMIF、YKL-40水平具有显著差异，临床可考虑应用EFI评分、血清MMIF、YKL-40水平来辅助判断子宫内膜异位症患者的卵巢功能与疾病严重程度。

The Relationship between EFI Score, Serum MMIF, YKL-40 and Ovarian Function, Clinical Stage of Patients with Endometriosis

ABSTRACT Objective: To explore the relationship between fertility index (EFI) score, serum macrophage migration inhibitory factor (MMIF), Chitin enzyme protein 40 (YKL-40), ovarian function and clinical stage of patients with Endometriosis. Methods: Eighty patients with Endometriosis admitted to our hospital from June 2020 to June 2023 were selected as the study subjects, and they were divided into an observation group. Eighty healthy female volunteers who came to our hospital for physical examination at the same time were selected as the control group. The EFI score, serum MMIF, YKL-40 and the expression level of ovarian function indicators of the two groups were compared. Eighty patients with Endometriosis were classified according to the American Association of Reproductive Medicine Endometriosis staging criteria (r-AFS), including 15 patients with stage I, 23 patients with stage II, 25 patients with stage III, and 17 patients with stage IV. The EFI scores, serum MMIF, and YKL-40 expression levels in patients with different r-AFS stages were compared. And the Spearman correlation analysis method was used to analyze the correlation between EFI score, serum MMIF, YKL-40, and ovarian function indicators. Results: The EFI score of the observation group was lower than that of the control group, and the expression levels of serum MMIF and YKL-40 were higher than those of the control group(P<0.05); The expression levels of anti Müllerian hormone (AMH), Luteinizing hormone (LH) and follicle stimulating hormone (FSH) in the observation group were lower than those in the control group, and the level of estradiol (E₂) was higher than that in the control group(P<0.05); The EFI scores of patients with Endometriosis in different stages from high to low were stage I, stage II, stage III, and stage IV, and the levels of MMIF and YKL-40 from high to low were stage IV, stage III, stage II, and stage I. The EFI scores, serum MMIF, and YKL-40 expression levels in different stages were significantly different(P<0.05); The Spearman correlation analysis showed that the EFI score was positively correlated with AMH, LH, FSH, and negatively correlated with E₂ (P<0.05). MMIF and YKL-40 were negatively correlated with AMH, LH, FSH, and positively correlated with E2(P<0.05). Conclusion: EFI score, serum MMIF, and YKL-40 levels are significantly correlated with the ovary of Endometriosis patients, and there are significant differences between the EFI score, serum MMIF, and YKL-40 levels of different Endometriosis patients. Clinical application of EFI score, serum MMIF, and YKL-40 levels can be considered to assist in judging the ovarian function and disease severity of Endometriosis patients.