血清AMH检测在多囊卵巢综合征中的应用价值研究
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摘要
目的探讨血清抗缪勒管激素(AMH)检测在多囊卵巢综合征(PCOS)诊断中的应用价值。方法选取2017年1月至2018年6月经临床诊断为多囊卵巢综合征患者206例,简称为研究组;其中雄性激素睾酮(T)浓度≤75ng/dL患者130例,简称为研究组A;雄性激素睾酮(T)浓度>75ng/dL患者76例,简称为研究组B。同期在健康管理中心招募206例女性为对照组,利用统计学软件分析多囊卵巢综合征患者和健康人群的AMH检测结果。结果研究组AMH浓度明显高于对照组,研究组B的AMH浓度明显高于研究组A,差异均有统计学意义(P<0.05);研究组AMH浓度与睾酮浓度呈正相关性,相关系数r=0.171且P<0.05;ROC曲线分析AMH诊断PCOS患者的线下面积为0.776,面积标准误为0.028,差异有统计学意义(P=0.000),以AMH浓度6.19ng/mL为PCOS诊断界值时,灵敏度为69%,特异度为71%。结论多囊卵巢综合征患者血清中AMH浓度显著升高,血清AMH浓度检测对多囊卵巢综合征的临床诊断有一定价值。
Objective To explore the application value of serum anti-Müllerian hormone(AMH)detection in polycystic ovarian syndrome(PCOS).Methods 206 patients with polycystic ovarian syndrome who were diagnosed as PCOS from January 2017 to June 2018 were selected as the study group.Among them,130 patients with testosterone(T)concentration≤75 ng/dL were named as study group A,and 76 patients with testosterone(T)concentration>75 ng/dL were named as study group B.In the same period,206 women were recruited in the health management center as the control group.The AMH detection results of patients with polycystic ovarian syndrome and healthy people were analyzed by statistical software.Results The AMH concentration in the study group was significantly higher than that in the control group,and the AMH concentration in the study group B was significantly higher than that in the study group A,and the differences were statistically significant(P<0.05).The AMH concentration in the study group was positively correlated with the testosterone concentration,and the correlation coefficient r was 0.171,and P<0.05.ROC curve analysis showed that the area under ROC curve of AMH diagnosis of PCOS patients was 0.776,area standard error was 0.028,and the difference was significant(P=0.000).When AMH concentration of 6.19 ng/mL was taken as PCOS diagnostic cut-off value,the sensitivity was 69%,and the specificity was 71%.Conclusion The serum AMH concentration in patients with PCOS was significantly increased,and the detection of AMH in serum has certain value in the clinical diagnosis of polycystic ovarian syndrome.
Objective To explore the application value of serum anti-Müllerian hormone(AMH)detection in polycystic ovarian syndrome(PCOS).Methods 206 patients with polycystic ovarian syndrome who were diagnosed as PCOS from January 2017 to June 2018 were selected as the study group.Among them,130 patients with testosterone(T)concentration≤75 ng/dL were named as study group A,and 76 patients with testosterone(T)concentration>75 ng/dL were named as study group B.In the same period,206 women were recruited in the health management center as the control group.The AMH detection results of patients with polycystic ovarian syndrome and healthy people were analyzed by statistical software.Results The AMH concentration in the study group was significantly higher than that in the control group,and the AMH concentration in the study group B was significantly higher than that in the study group A,and the differences were statistically significant(P<0.05).The AMH concentration in the study group was positively correlated with the testosterone concentration,and the correlation coefficient r was 0.171,and P<0.05.ROC curve analysis showed that the area under ROC curve of AMH diagnosis of PCOS patients was 0.776,area standard error was 0.028,and the difference was significant(P=0.000).When AMH concentration of 6.19 ng/mL was taken as PCOS diagnostic cut-off value,the sensitivity was 69%,and the specificity was 71%.Conclusion The serum AMH concentration in patients with PCOS was significantly increased,and the detection of AMH in serum has certain value in the clinical diagnosis of polycystic ovarian syndrome.
引文
[1]曹泽毅.中华妇产科学[M].北京:人民卫生出版社,1999:2181-2185.
[2]袁利,程明刚,刘香萍,等.深圳地区健康育龄妇女血清中AMH水平现况及其在PCOS和POF诊疗中的价值[J].现代检验医学杂志,2017,32(5):141-144.
[3] Rotterdam Eshre/asrm-sponsored PCOS Consensus Workshop group.Revised 2003consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome(PCOS)[J].Hum Reprod,2004,19(1):41-47
[4]熊紫薇,胡坚,陈薪宇,等.抗缪勒氏管激素在多囊卵巢综合征诊断中的价值[J].分子影像学杂志,2015,38(2):80-83.
[5]徐金龙,王依屹,蒋国静,等.血清抗苗勒氏管激素检测在多囊卵巢综合征中的临床应用[J].国际检验医学杂志,2017(1):35-36.
[6] NADERI Z,KASHANIAN M,CHENARI L,et al.Evaluating the effects of administration of 25-hydroxyvitamin D supplement on serum anti-mullerian hormone(AMH)levels in infertile women[J].Gynecol Endocrinol,2018,34(5):409-412.
[7] WEENEN C,LAVEN J S,BERGH A R M V,et al.AntiMüllerian hormone expression pattern in the human ovary:potential implications for initial and cyclic follicle recruitment[J].Mol Hum Reprod,2004,10(2):77-83.
[8]沈涌海,施新颜,王智毅,等.抗缪勒管激素与游离睾酮指数在多囊卵巢综合征诊断中的应用价值[J].中国卫生检验杂志,2018,28(23):2867-2869.
[9]汪莎,赵旸,杨欣.抗苗勒氏管激素在妇科内分泌及生殖领域的临床应用进展[J].中国妇产科临床杂志,2018,19(06):566-568.
[10]胡平.抗缪勒氏管激素在多囊卵巢综合征诊断中的临床价值[J].成都医学院学报,2018,13(04):490-492.
[11]李洁.抗缪勒氏管激素诊断多囊卵巢综合征的价值分析[J].医学理论与实践,2018(20):3022-3023.
[12]梁光林,郑文玲,刘传勇,等.PCOS患者内分泌代谢异常与AMH水平的关系研究[J].中国医药科学,2018,8(15):254-256.
[13]PIOUKA A,FARMAKIOTIS D,KATSIKIS I,et al.Anti-Mullerian hormone levels reflect severity of PCOS but are negatively influenced by obesity:relationship with increased luteinizing hormone levels[J].Am J Physiol Endocrinol Metab,2009,296(2):238.
[14]丁娇,邵军晖,简皓,等.抗苗勒氏管激素(AMH)与多囊卵巢综合征相关性的临床研究[J].当代医学,2018,24(28):93-95.
[15]李轶,李瑞岐,欧颂邦,等.高雄激素和非高雄激素型多囊卵巢综合征患者血清抗苗勒管激素分泌特点及诊断效能比较[J].实用妇产科杂志,2014,30(02):111-115.
[2]袁利,程明刚,刘香萍,等.深圳地区健康育龄妇女血清中AMH水平现况及其在PCOS和POF诊疗中的价值[J].现代检验医学杂志,2017,32(5):141-144.
[3] Rotterdam Eshre/asrm-sponsored PCOS Consensus Workshop group.Revised 2003consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome(PCOS)[J].Hum Reprod,2004,19(1):41-47
[4]熊紫薇,胡坚,陈薪宇,等.抗缪勒氏管激素在多囊卵巢综合征诊断中的价值[J].分子影像学杂志,2015,38(2):80-83.
[5]徐金龙,王依屹,蒋国静,等.血清抗苗勒氏管激素检测在多囊卵巢综合征中的临床应用[J].国际检验医学杂志,2017(1):35-36.
[6] NADERI Z,KASHANIAN M,CHENARI L,et al.Evaluating the effects of administration of 25-hydroxyvitamin D supplement on serum anti-mullerian hormone(AMH)levels in infertile women[J].Gynecol Endocrinol,2018,34(5):409-412.
[7] WEENEN C,LAVEN J S,BERGH A R M V,et al.AntiMüllerian hormone expression pattern in the human ovary:potential implications for initial and cyclic follicle recruitment[J].Mol Hum Reprod,2004,10(2):77-83.
[8]沈涌海,施新颜,王智毅,等.抗缪勒管激素与游离睾酮指数在多囊卵巢综合征诊断中的应用价值[J].中国卫生检验杂志,2018,28(23):2867-2869.
[9]汪莎,赵旸,杨欣.抗苗勒氏管激素在妇科内分泌及生殖领域的临床应用进展[J].中国妇产科临床杂志,2018,19(06):566-568.
[10]胡平.抗缪勒氏管激素在多囊卵巢综合征诊断中的临床价值[J].成都医学院学报,2018,13(04):490-492.
[11]李洁.抗缪勒氏管激素诊断多囊卵巢综合征的价值分析[J].医学理论与实践,2018(20):3022-3023.
[12]梁光林,郑文玲,刘传勇,等.PCOS患者内分泌代谢异常与AMH水平的关系研究[J].中国医药科学,2018,8(15):254-256.
[13]PIOUKA A,FARMAKIOTIS D,KATSIKIS I,et al.Anti-Mullerian hormone levels reflect severity of PCOS but are negatively influenced by obesity:relationship with increased luteinizing hormone levels[J].Am J Physiol Endocrinol Metab,2009,296(2):238.
[14]丁娇,邵军晖,简皓,等.抗苗勒氏管激素(AMH)与多囊卵巢综合征相关性的临床研究[J].当代医学,2018,24(28):93-95.
[15]李轶,李瑞岐,欧颂邦,等.高雄激素和非高雄激素型多囊卵巢综合征患者血清抗苗勒管激素分泌特点及诊断效能比较[J].实用妇产科杂志,2014,30(02):111-115.