ROC 曲线比较多囊卵巢综合征患者各项雄激素指标的变化意义  

Significance of the changes of androgen indicators in patients with polycystic ovary syndrome by ROC curve

作　　者：张念[1] 李留霞[1] 张颖[1] 王苗苗[1] 

机构地区：[1]郑州大学第一附属医院妇产科,450052

出　　处：《中国实用医刊》2017年第4期63-66,共4页Chinese Journal of Practical Medicine

摘　　要：目的：探讨多囊卵巢综合征（PCOS）患者雄激素指标性激素结合蛋白（SHBG）、睾酮（TT）、硫氢表雄酮（DHEA-S）、雄烯二酮（A4）及游离睾酮指数（FAI）对于 PCOS 诊断的敏感性和准确性。方法分析300例PCOS患者及120例月经及排卵正常女性（对照组）的临床表现和各生化雄激素指标，其中 PCOS 组又分为有高雄症状组和无高雄症状组，检测患者 TT、SHBG、DHEA-S、A4，并计算 FAI，比较各组各项指标的变化，通过 ROC 曲线比较曲线下面积，比较各检验指标的敏感度及特异度。结果 PCOS 患者体内 T、DHEA-S、A4和 FAI 高于对照组（P ﹤0.05），SHBG 低于对照组（P ﹤0.05）。曲线下面积 SHBG（0.767）、DHEA-S（0.637）对应灵敏度较低，而 FAI、A4、TT对于 PCOS 诊断具有较高的价值。其中以 FAI 灵敏度最高（89.8%），其次为 A4（69.0%），TT 仅为48.6%。而高雄激素临床表现上 FAI（92.0%）﹥ A4（75.0%）﹥ TT（53.5%）﹥ SHBG（21.6%）﹥ DHEA-S（11.4%），A4和 FAI 在PCOS患者诊断价值较 TT 具有更高的敏感性。结论 A4和 FAI 在 PCOS 患者诊断价值优于 TT，具有更高的敏感性。FAI 可作为诊断 PCOS 高雄激素血症的敏感及准确性指标，此检测方法比较简单、快速，适合在临床推广。Objective To investigate the diagnostic sensitivity and accuracy with androgen in-dexsuch as sex hormone binding（ SHBG）,total testosterone（ TT）,dehydroepiandrosteron sulphate （DHEA-S）,androstenedione（A4）and free testosterone index（FAI）in patients with polycystic ovary syn-drome（PCOS）. Methods The clinical manifestation and biochemical index of androgen with 300 PCOS patients（PCOS group）and 120 normal women（control group）were analyzed,and the patients in PCOS group were divided into hyperandrogerisn symptoms group and without hyperandrogerisn symptoms group. The levels of TT,SHBG,DHEA-s,A4 were detected and the FAI was calculated. The changes of each androgen index between the two groups were compared,and the sensitivity and specificity of the test inde-xes by the area of ROC curve were compared. Results In PCOS group,the levels of TT,DHEA-S,A4 and FAI were higher than those in control group（P ﹤ 0. 05）,SHBG was lower than that in control group （P ﹤ 0. 05）. The area under the curve of SHBG（0. 767）and DHEA-S（0. 637）meas its sensitivity was low,FAI（0. 894）,A4（0. 864）,TT（0. 840）for PCOS with high diagnosed value. The sensitivity of FAI was highest（89. 8% ）,followed by A4（69% ）,TT was only 48. 6% . And on hyperandrogerisn symptoms group：FAI（92. 0% ） ﹥ A4（75. 0% ） ﹥ TT（53. 5% ） ﹥ SHBG（21. 6% ） ﹥ DHEA-S （11. 4% ）,A4 and FAI in patients with PCOS had high diagnosis value than TT. Conclusions The val-ue of A4 and FAI in the diagnosis of PCOS is better than TT,it has higher sensitivity. FAI can be used as as a sensitive and accurate indicator for diagnosis of PCOS with high androgen levels,and this test method is simple,rapid,suitable for clinical promotion.

关 键 词：多囊卵巢综合征 睾酮 雄烯二酮 游离雄激素指数 ROC 曲线 

分 类 号：R711.75[医药卫生—妇产科学]