抗苗勒管激素对氯米芬抵抗的PCOS妇女腹腔镜术后卵巢反应性预测价值  

Predictive Value of Anti-mullerian Hormone on Ovary Response in PCOS Patients with Clomiphene Citrate(CC)-resistant after Laparoscopic Ovarian Drilling

作　　者：韦成厚[1] 沈宏伟[2] 朱国平[1] 

机构地区：[1]广东省计划生育科学技术研究所．广东广州510600 [2]中山大学附属第一医院妇产科,广东广州510080

出　　处：《中山大学学报（医学科学版）》2012年第1期99-101,106,共4页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：广东省自然科学基金(10151008010000002)

摘　　要：【目的】探讨测定术前血清抗苗勒管激素(AMH)水平对氯米芬(CC)抵抗的多囊卵巢综合征(PCOS)妇女腹腔镜术后卵巢反应性预测价值。【方法】应用酶联免疫吸附(ELISA)法检测腹腔镜卵巢打孔术(LOD)54例氯米芬抵抗的PCOS患者术前血清基础AMH水平,术后用B超和尿LH峰监测卵巢卵泡发育及排卵情况,并用ROC曲线分析监测结果。【结果】ROC曲线分析表明,AMH对术后卵巢高和低反应性均为中等诊断价值,其AUC分别是0.792和0.846(95%CI:0.673-0.911和0.696-0.996;P=0.000和P=0.002)。以血清AMH7.4 ng/mL和4.3 ng/mL分别为预测卵巢高和低反应性最佳诊断界值,灵敏度分别为73.1%和87.5%,特异度分别为71.4%和66.7%,阳性预测值分别为71.9%和72.4%,阴性预测值分别为72.6%和84.2%。【结论】测定术前血清基础AMH水平可以预测CC抵抗的PCOS妇女腹腔镜术后卵巢高和低排卵反应性,并可以作为评估LOD手术有效性的一个有价值预测指标。[ Objective] To investigate the predictive diagnostic value of preoperation serum anti-mullerian hormone （AMH） level measurement on ovary ovulation response after laparoscopic ovarian drilling （LOD） in PCOS patients with clomiphene citrate（CC）- resistant. [ Methods ] 54 PCOS patients with clomiphene citrate （CC）-resistant were enrolled LOD. Serum AMH levels were measured by enzyme linked immunosorbent assay （ELISA）, Follicle growth and ovulation situation were supervised by vaginial ultrasound and urine LH peak. Using ROC （receiver operating characteristic） curve analysis monitoring data. [ Results ] ROC curve analysis indicated that AMH had moderate diagnostic value for postoperation high and poor ovary response. Theirs AUC （area under the curve, AUC） were 0.792 and 0.846 （95%CI： 0.673-0.911 and 0.696-0.996; P = 0.000 and P = 0.002）. Serum AMH at 7.4 ng/mL and 4.3 ng/ mL were optium cutoff value for predictive high and poor ovary response, respectively. Sensitivity were 73.1% and 87.5% , respectively. Specificity were 71.4% and 66.7%, respectively. Positive predictive value were 71.9% and 72.4%, respectively. Negative predictive values were 72.6% and 84.2%, respectively. [Conclusions] The prenperation measurement of serum basal AMH level can predictive the high and poor ovary response after LOD in PCOS patients with clomiphene citrate（CC）-resistant, and act as a single valued predictive index in estimating LOD effectiveness.

关 键 词：抗苗勒管激素 多囊卵巢综合征 腹腔镜卵巢打孔术 预测价值 

分 类 号：R713.6[医药卫生—妇产科学]