卵巢囊肿术后患者外周血Th17/Treg和性激素及AMH变化对患者卵巢储备功能的预测价值OA

Objective To investigate the predictive value of postoperative changes in peripheral blood T helper 17/regulatory T cell(Th17/Treg)ratio,sex hormones,and anti-Müllerian hormone(AMH)for ovarian reserve function in patients undergoing surgery for ovarian cysts.Methods A total of 120 patients with ovarian cysts who underwent sur-gical treatment between January and December 2024 were enrolled as the patient group.During the same period,120 healthy women were recruited as the control group.Baseline characteristics and postoperative levels of peripheral blood Th17/Treg ratio,sex hormones[follicle-stimulating hormone(FSH),estradiol(E2),and luteinizing hormone(LH)],and AMH were compared between the two groups.Patients in the ovarian cyst group were followed up postoperatively to e-valuate dynamic changes in Th17/Treg ratio,sex hormones(FSH,E2,LH),and AMH at 1,3,and 6 months after sur-gery.According to postoperative ovarian reserve status,patients were further divided into an ovarian reserve decline group(n=41)and a normal ovarian reserve group(n=79).Differences in clinical and laboratory indicators between the two groups were analyzed.Multivariate binary logistic regression analysis was used to identify factors associated with ovarian reserve decline.Receiver operating characteristic(ROC)curve analysis was performed to assess the predictive value of postoperative peripheral blood indicators for ovarian reserve function.Results No significant differences in baseline char-acteristics were observed between the control group and the patient group(P＞0.05).At 1 month postoperatively,the Th17/Treg ratio,FSH,E2,and LH levels in the patient group were significantly increased compared with preoperative levels(P＜0.05),whereas AMH levels were significantly decreased(P＜0.05).Within 6 months after surgery,these indicators gradually recovered,with significant decreases in Th17/Treg ratio,FSH,E2,and LH levels and a significant increase in AMH levels(all P＜0.05).The cyst diameter in the ovarian reserve decline group was significantly larger than that in the normal ovarian reserve group(P＜0.05),while no significant differences were observed in other baseline variables(P＞0.05).The ovarian reserve decline group showed significantly higher Th17/Treg ratios at 1,3,and 6 months postoperatively and higher FSH levels at 6 months postoperatively(P＜0.05),as well as significantly lower AMH levels at 1,3,and 6 months postoperatively(P＜0.05),compared with the normal ovarian reserve group.Th17/Treg ra-tio,FSH,and AMH levels at 6 months postoperatively were significantly associated with ovarian reserve decline(P＜0.05).The areas under the ROC curve(AUCs)for predicting ovarian reserve decline were 0.908 for Th17/Treg ratio at 6 months,0.810 for FSH at 6 months,and 0.767 and 0.826 for AMH at 3 and 6 months,respectively.Combined detec-tion yielded an AUC of 0.986,with a sensitivity of 97.56％and a specificity of 73.42％,indicating high predictive val-ue.Conclusion Postoperative ovarian reserve decline in patients with ovarian cysts is associated with abnormal increases in peripheral blood Th17/Treg ratio and FSH levels and abnormal decreases in AMH levels.These findings warrant in-creased clinical attention and suggest that combined monitoring of these indicators may be valuable for early prediction of o-varian reserve impairment.