血清抗苗勒管激素诊断多囊卵巢综合征的临床价值  

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

作　　者：杨小岗[1] 王芳[2] 武佳敏 董永生[4] 赵志刚[1] 武保乡 武春燕 

机构地区：[1]邯郸市第一医院核医学科,河北省056002 [2]河北工程大学医学院护理系 [3]邯郸和平医院不育症科 [4]邯郸市妇幼保健院小儿外科

出　　处：《中华临床医师杂志（电子版）》2011年第13期3721-3725,共5页Chinese Journal of Clinicians(Electronic Edition)

基　　金：邯郸市科学技术研究与发展计划资助项目(1023108098-3)

摘　　要：目的探讨抗苗勒管激素(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。方法用酶联免疫吸附法(ELISA)测定155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)水平及LH/FSH值,并与134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)AMH10.45ng/ml、T0.83ng/ml、LH10.21mIU/ml水平,明显高于对照组(AMH5.14ng/ml、T0.77ng/ml、LH5.03mIU/ml),两组差异有统计学意义(P<0.01);PCOS组E268.62pg/ml明显低于对照组(116.05pg/ml),两组差异有统计学意义(P=0.000);LH/FSH比值两组间无显著差异(P=0.877)。(2)以AMH诊断PCOS的ROC曲线下面积为0.828,面积的标准误为0.023,差异有显著意义(P=0.000);AMH诊断PCOS的最佳界值为6.865ng/ml时的敏感度为75.48%,特异度为73.63%,诊断效能中等。结论测定血清AMH水平可作为PCOS诊断和研究新的重要方法,而LH/FSH比值不宜作为PCOS的诊断指标。Objective To explore the characteristic relationship between the anti-Mullerian hormone(AMH)and the PCOS hormone and use the ROC curve method to evaluate the diagnosis value of AMH for PCOS.Methods Used the enzyme-linked immunosorbent assay(ELISA)to detect the serum level of AMH,follicle-stimulating hormone(FSH),luteinizing hormone(LH),testosterone(T),the estradiol(E2) and the LH/FSH value in 155 patients with PCOS,and carried on comparing with 134 women with normal menstrual cycle(control group).At the same time,drawh up the ROC curve with SPSS and statistical analyzed these datum.Results(1)The serum hormone levels(AMH 10.45 ng/ml,T 0.83 ng/ml,LH 10.21 mIU/ml)of PCOS group were obviously higher thanthose of control group(AMH 5.14 ng/ml,T 0.77 ng/ml,LH 5.03 mIU/ml)(P<0.01).The E2 level of PCOS group(68.62 pg/ml) was obviously lower than that of control group(116.05 pg/ml)(P=0.000).LH/FSH ratio of the two groups had no remarkable differences(P=0.877).(2)The area under the ROC curve for PCOS diagnosed by AMH was 0.828.The standard error of area was 0.023 which has the remarkable significance(P=0.000);while the best dividing value of PCOS diagnosed by AMH was 6.865 ng/ml,the sensitivity was 75.48%,specificity was 73.63% and diagnostic efficiency was medium.Conclusions Detecting serum AMH level is a novel and important method of PCOS diagnosis and research,but it is not suitable for taking the LH/FSH ratio as diagnosis indicator of PCOS.

关 键 词：多囊卵巢综合征 抗苗勒管激素 ROC曲线 诊断 

分 类 号：R711.75[医药卫生—妇产科学]