抗缪勒氏管激素在多囊卵巢综合征诊断中的价值

熊紫薇; 胡坚; 陈薪宇; 杨卫; 刘刚

抗缪勒氏管激素在多囊卵巢综合征诊断中的价值

熊紫薇^1,2,,
胡坚³,
陈薪宇²,
杨卫²,
刘刚^1, ,

1.
中南大学生殖与干细胞工程研究所，湖南长沙 410008
2.
湖南光琇医院，湖南长沙 410205
3.
中信湘雅生殖与遗传专科医院，湖南长沙 410008

详细信息

作者简介:
熊紫薇，在读硕士研究生，主管检验师，E-mail: 40300646@qq.com

通讯作者:
刘刚，博士，副研究员，博士生导师，电话：0731-82355100-8901，E-mail: 616778747@qq.com

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出版历程
- 收稿日期: 2014-10-21
- 刊出日期: 2015-02-01

Clinical value of serum anti-mullerian hormone in diagnosis of polycystic ovarian syndrome

Ziwei Xiong^{1,2
,},
Jian Hu³,
Xinyu Chen²,
Wei Yang²,
Gang Liu^{1
, ,}

1.
Institute of Reproduction and Stem Cell Engineering, Central South University Changsha 410008, China
2.
Hunan Guagnxiu Hospital, Changsha 410205 China
3.
Reproductive and Genetic Hospital of CITIC-XIANGYA, Changsha 410008, China

摘要

摘要: 目的研究抗苗勒管激素（AMH）与多囊卵巢综合征（PCOS）激素特征的关系及使用ROC曲线法评价AMH对PCOS的诊断价值。方法576例PCOS患者血清AMH、卵泡刺激素（FSH）、黄体生成素（LH）、睾酮（T）、雌二醇（E2）水平用电化学发光法检测，并与503例月经周期正常妇女进行对照。用SPSS绘制ROC曲线及统计分析。结果（1）PCOS组血清激素（中位数）AMH 10.46 ng/ml、E2 40.92、LH 6.67、T 0.78水平，明显高于对照组AMH 3.65 ng/ml、E2 35.97、LH 6.45、T 0.48，且差异均具有统计学意义（P < 0.05）；PCOS组FSH 5.14明显低于对照组（6.45），且差异具有统计学意义（P < 0.05）；（2）Pearson相关分析显示PCOS组AMH与T、LH均呈正相关（相关系数分别为0.276，0.221，P < 0.05）；与FSH呈负相关（r=-0.113，P < 0.05）；与年龄、E2无明显相关；（3）以AMH诊断PCOS的ROC曲线下面积为0.926，面积的标准误为0.008，差异有显著意义（P=0.000）；以AMH 6.99 ng/ml为PCOS诊断界值时，敏感性84%，特异性92%，诊断效能较高/价值明显高于E2、FSH、LH、T及年龄等其他指标。结论PCOS患者血清AMH显著升高，其升高可能与激素紊乱和卵泡发育异常有关。
- 抗缪勒氏管激素 /
- 多囊卵巢综合征 /
- ROC
Abstract: ObjectiveTo explore the relationship between anti-Mullerian hormone (AMH) and the PCOS hormone and use the ROC curve method to evaluate the diagnosis value of AMH for PCOS.MethodsThe enzyme-linked immunosorbent assay (ELISA) was used to detect the serum level of AMH, the estradiol (E₂), follicle-stimulating hormone (FSH), luteinizing hormone (LH), and the testosterone (T) in 503 patients with PCOS, and carried on comparing with 576 women with normal menstrual cycle (control group). Meanwhile, drawh up the ROC curve with SPSS and statistical analyzed these datum.Results(1) The serum hormone levels (AMH 10. 46 ng/ml, E₂ 40.92, LH 6.67 mU/ml, T 0.78) of PCOS group were obviously higher than those of control group (AMH 3.65 ng /ml, E₂ 35.97、LH 6.45、T 0.48) (P < 0.05). The FSH level of PCOS group (5.14) was obviously lower than that of control group (6.45)(P < 0.05). (2) Pearson correlation analysis showed positive relationship between serum AMH and LH (r=0.276, P < 0.05) as well as T (r=0.221, P < 0.05). Serum AMH level in PCOS group was nagatively collelated with FSH (r=-0.113, P < 0.05). No significant relationships were found between serum AMH and age, E2 level. (3) The area under the ROC curve for PCOS diagnosed by AMH was 0.926. The standard error of area was 0.008 which has the remarkable significance (P=0.000); while the best dividing value of PCOS diagnosed by AMH was 6.99 ng /ml, the sensitivity was 84%, specificity was 92% and diagnostic efficiency was high. Conclusions Serum AMH level was elevated in patients with PCOS and this may have correlation with hormone imbalance and abnormal follicular development.
- polycystic ovary syndrome /
- anti-mullerian hormone /
- ROC

HTML全文

图 1 以AMH、E2、FSH、LH、T值及年龄诊断PCOS的ROC曲线

下载: 全尺寸图片幻灯片

表 1 PCOS组和对照组血清AMH及生殖激素水平结果比较

组別	对照组	PCOS组
例数	576	503
年龄(岁）	29.84±4.42	27.93±3.75
AMH (ng/ml)	3.65±2.71	10.46±3.89*
E2(pg/ml)	35.97±17.49	40.92±50.58*
FSH (mU/ml)	6.45±2.05	5.14±1.27*
LH (mU/ml)	4.53±2.64	6.76±4.37*
T (ng/ml)	0.48±0.33	0.78±0.48*
*:与对照组比较，P < 0.05.

下载: 导出CSV

表 2 PCOS组与对照组血清AMH和生殖激素水平及年龄之间的相关性

组别	对照组		PCOS组
例数	576		503
相关性	r	P	r	P
年龄(岁）	-0.300	0.000	-0.051	0.257
E2(pg/ml)	-0.053	0.206	0.043	0.339
FSH (mU/ml)	-0.199	0.000	-0.113	0.011
LH (mU/ml)	0.384	0.000	0.221	0.000
T (mg/ml)	0.005	0.906	0.276	0.000

下载: 导出CSV

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