Abstract:

Abstract：Objective To study character of the serum sex hormone binding globulin (SHBG) level and insulin resistance in patients with history of recurrent spontaneous abortion during early pregnancy, evaluate the outcome of pregnancy. Methods 122 patients with history of recurrent spontaneous abortion registered for treatment in the Shengjing Hospital of China Medical University between June 2011 and June 2013 were selected into case group. 56 healthy women during early pregnancy were selected into control group.In pregnancy 8-10 weeks,data and serum specimens of women were collected in the cases group and the control group. To detect the indexes of SHBG, fasting blood glucose (FPG),fasting insulin (FINS), estradiol (E2), testosterone (T), dehydroepiandrosterone sulfate (DHEAS). Serum SHBG determination by enzyme linked immunosorbent assay (ELISA) method. FPG determinate by oxidase method. FINS,E2,T,DHEAS detected by chemiluminescence immunoassay.Results （1）Maternal body height, diastolic blood pressure and detecting gestational weeks in comparison, their difference in case group and in control has no statistical significance（P>0.05).The age of pregnancy women in case group and in control group in comparison, their difference has statistical significance（P<0.05).The body weight, body mass index, systolic blood pressure, previous pregnancy and history of recurrent spontaneous abortion in case group and in control group in comparison, their difference has statistical significance (P<0.01). （2）The SHBG,FPG,FINS,HOMA-IR and DHEAS in case group and in control group in comparison, their difference has statistical significance (P<0.01).The E2 and T of pregnancy women in case group and in control group in comparison, their difference has no statistical significance（P>0.05). （3）Body height, body mass index,SHBG and DHEAS in analysis of multiplicity were the influencing factors on recurrent spontaneous abortion (P<0.01). Conclusion Insulin resistance in early pregnancy women with history of recurrent spontaneous abortion increased than normal pregnant women，and HOMA-IR decreased than normal pregnant women. SHBG were one of the influencing factors on recurrent spontaneous abortion.

Key words: recurrent spontaneous abortion, IR, sex hormone binding globulin, early pregnancy

摘要：

目的 探讨复发性流产患者孕早期血清性激素结合球蛋白（sex hormone binding globulin，SHBG）和胰岛素抵抗指数的特征。方法 选择2011年6月至2013年6月在中国医科大学附属盛京医院就诊的有复发性流产史孕妇122例为病例组，56例同期就诊无不良孕产史健康早孕妇女为对照组。于妊娠8～10周收集病例组及对照组个人资料和血清标本。检测指标为SHBG、空腹血糖（FPG）、空腹胰岛素（FINS）、雌二醇（E2）、睾酮（T）、硫酸脱氢表雄酮（DHEAS）。血清SHBG采用酶联免疫吸附试验(ELISA)法测定，FPG采用氧化酶法测定，FINS、E2、T、DHEAS采用化学发光免疫分析法测定。 结果 （1）病例组和对照组孕妇身高、舒张压和检测时孕周比较差异无统计学意义（P>0.05）；两组孕妇年龄、体重、体重指数、收缩压、孕次和既往流产史比较差异有统计学意义（P<0.05）。（2）与对照组比较，病例组孕妇SHBG水平显著降低，FPG、FINS、胰岛素抵抗指数（HOMA-IR）和DHEAS显著升高，差异均有统计学意义（P<0.01）；E2和T水平比较差异无统计学意义（P>0.05）。（3）多因素分析显示身高、体重指数、SHBG和DHEAS是复发性流产的影响因素（P<0.05）。结论 有复发性流产史患者孕早期SHBG较正常孕妇降低，胰岛素抵抗指数较正常孕妇升高，SHBG是复发流产的影响因素之一。

关键词: 复发性流产, 胰岛素抵抗, 性激素结合球蛋白, 早期妊娠