抗穆勒氏管激素和睾酮检测对多囊卵巢综合征的预测价值
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摘要
目的探讨抗穆勒氏管激素(AMH)、睾酮(T)及两者联合检测对多囊卵巢综合征(PCOS)的诊断价值。方法选取2015年7月—2017年9月在厦门大学附属第一医院生殖医学科就诊的PCOS患者210例作为PCOS组,选择因男方因素不孕而于生殖医学科就诊的健康女性288例作为对照组。比较两组促卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)、孕激素(P)、泌乳素(PRL)、睾酮(T)和抗穆勒氏管激素(AMH)水平,用SPSS绘制ROC曲线及统计分析。结果(1)PCOS组LH、T、AMH均明显高于对照组,FSH、E2均明显低于对照组(P <0.05)。(2)AMH预测PCOS的敏感度为79.05%,特异度为69.44%;T预测PCOS的敏感度为66.67%,特异度为67.36%;AMH联合T预测PCOS的敏感度为82.86%,特异度为67.71%。结论 AMH与T联合检测预测PCOS的敏感度高于AMH单项检测,对PCOS的临床预测有重要的指导意义。
Objective To explore the diagnostic value of anti-Müllerian hormone(AMH), testosterone(T) and combined test of them in patients with Polycystic ovary Syndrome(PCOS). Methods A total of 210 PCOS patients from the reproductive medicine department of the First Affiliated Hospital of Xiamen University from July 2015 to September 2017 were selected as PCOS group, and 288 healthy women were selected as the controls. The levels of follicle-stimulating hormone(FSH), luteinizing hormone(LH), estradiol(E2) and testosterone(T), AMH were compared in different groups. The ROC curve and statistical analysis were plotted with SPSS. Results(1) LH, T and AMH levels in the PCOS group were significantly higher than those in the controls. FSH and E2 levels in the PCOS group were significantly lower than those in the controls(P < 0.05).(2) The sensitivity of AMH to predict PCOS was 79.05%, and the specificity was 69.44%. The sensitivity of T to predict polycystic ovary syndrome was 66.67% and the specificity was 67.36%. The sensitivity of AMH combined with T to predict polycystic ovary syndrome was 82.86% and the specificity was 67.71%. Conclusion The sensitivity of AMH combined with T test was higher than that of AMH test only, which is of great guiding significance for the prediction of clinical PCOS.
Objective To explore the diagnostic value of anti-Müllerian hormone(AMH), testosterone(T) and combined test of them in patients with Polycystic ovary Syndrome(PCOS). Methods A total of 210 PCOS patients from the reproductive medicine department of the First Affiliated Hospital of Xiamen University from July 2015 to September 2017 were selected as PCOS group, and 288 healthy women were selected as the controls. The levels of follicle-stimulating hormone(FSH), luteinizing hormone(LH), estradiol(E2) and testosterone(T), AMH were compared in different groups. The ROC curve and statistical analysis were plotted with SPSS. Results(1) LH, T and AMH levels in the PCOS group were significantly higher than those in the controls. FSH and E2 levels in the PCOS group were significantly lower than those in the controls(P < 0.05).(2) The sensitivity of AMH to predict PCOS was 79.05%, and the specificity was 69.44%. The sensitivity of T to predict polycystic ovary syndrome was 66.67% and the specificity was 67.36%. The sensitivity of AMH combined with T to predict polycystic ovary syndrome was 82.86% and the specificity was 67.71%. Conclusion The sensitivity of AMH combined with T test was higher than that of AMH test only, which is of great guiding significance for the prediction of clinical PCOS.
引文
[1]郭成焕.二甲双胍联合来曲唑治疗多囊卵巢综合征不孕症临床效果[J].中国卫生标准管理,2018,9(11):70-71.
[2]王虎生,阮祥燕,李雪,等.抗苗勒管激素与抑制素B对多囊卵巢综合征的临床预测价值[J].首都医科大学学报,2017,38(4):492-497.
[3]刘梅梅,丁慧,尹晓静,等.多囊卵巢综合征患者血清血管内皮生长因子、内皮抑素水平及对卵巢间质血流的影响研究[J].中国全科医学,2017,20(4):448-453.
[4]Dumesic DA,Akopians AL,Madrigal VK,et al. Hyperandrogenism accompanies increased intra-abdominal fat storage in normal weight polycystic ovary syndrome women[J]. J Clin Endocrinol Metab,2016,101(11):4178-4188.
[5]Albu A,Florea S,Fica S. Is prolactin the missing link in adipose tissuedysfunctionofpolycysticovarysyndromepatients[J].Endocrine,2016,51(1):163-173.
[6]Glintborg D,Altinok M,Mumm H,et al. Prolactin is associated with metabolic risk and cortisol in 1007 women with polycystic ovary syndrome[J]. Hum Reprod,2014,29(8):1773-1779.
[7]Li J,Li R,Yu H,et al.The relationship between serum antiMullerian hormone levels and the follicular arrest for women with polycystic ovary syndrome[J]. Syst Biol Reprod Med,2015,61(2):103-109.
[8]赖海燕,桂文武.抗苗勒管激素在辅助生殖领域的临床研究进展[J].国际生殖健康/计划生育杂志,2018,37(1):71-75.
[9]李惠敏,吴惠华,孟庆霞,等.抗苗勒管激素在IVF治疗多囊卵巢综合征患者中的应用价值探讨[J].南京师大学报(自然科学版),2018,41(01):88-96.
[10]Melado Vidales L,Fernández-Nistal A,Martínez Fernández V,et al. Anti-Müllerian hormone levels to predict oocyte maturity and embryo quality during controlled ovarian hyperstimulation[J]. Minerva Ginecologica,2017,69(3):225-232.
[11]田玄玄,阮祥燕,王娟,等. 437例多囊卵巢综合征相关因素调查分析[J].首都医科大学学报,2014,35(4):414-418.
[12]杨颖,王金敏,彭书苹,等.肥胖型多囊卵巢综合征患者临床特征分析[J].中国煤炭工业医学杂志,2014,17(9):1453-1455.
[2]王虎生,阮祥燕,李雪,等.抗苗勒管激素与抑制素B对多囊卵巢综合征的临床预测价值[J].首都医科大学学报,2017,38(4):492-497.
[3]刘梅梅,丁慧,尹晓静,等.多囊卵巢综合征患者血清血管内皮生长因子、内皮抑素水平及对卵巢间质血流的影响研究[J].中国全科医学,2017,20(4):448-453.
[4]Dumesic DA,Akopians AL,Madrigal VK,et al. Hyperandrogenism accompanies increased intra-abdominal fat storage in normal weight polycystic ovary syndrome women[J]. J Clin Endocrinol Metab,2016,101(11):4178-4188.
[5]Albu A,Florea S,Fica S. Is prolactin the missing link in adipose tissuedysfunctionofpolycysticovarysyndromepatients[J].Endocrine,2016,51(1):163-173.
[6]Glintborg D,Altinok M,Mumm H,et al. Prolactin is associated with metabolic risk and cortisol in 1007 women with polycystic ovary syndrome[J]. Hum Reprod,2014,29(8):1773-1779.
[7]Li J,Li R,Yu H,et al.The relationship between serum antiMullerian hormone levels and the follicular arrest for women with polycystic ovary syndrome[J]. Syst Biol Reprod Med,2015,61(2):103-109.
[8]赖海燕,桂文武.抗苗勒管激素在辅助生殖领域的临床研究进展[J].国际生殖健康/计划生育杂志,2018,37(1):71-75.
[9]李惠敏,吴惠华,孟庆霞,等.抗苗勒管激素在IVF治疗多囊卵巢综合征患者中的应用价值探讨[J].南京师大学报(自然科学版),2018,41(01):88-96.
[10]Melado Vidales L,Fernández-Nistal A,Martínez Fernández V,et al. Anti-Müllerian hormone levels to predict oocyte maturity and embryo quality during controlled ovarian hyperstimulation[J]. Minerva Ginecologica,2017,69(3):225-232.
[11]田玄玄,阮祥燕,王娟,等. 437例多囊卵巢综合征相关因素调查分析[J].首都医科大学学报,2014,35(4):414-418.
[12]杨颖,王金敏,彭书苹,等.肥胖型多囊卵巢综合征患者临床特征分析[J].中国煤炭工业医学杂志,2014,17(9):1453-1455.