改良简化的Ferriman-Gallwey评分系统在中国女性多毛评价中的应用分析  

Simplified Analysis of Modified Ferriman-Gallwey Scoring System in Evaluation of Chinese Women——A Prospective Follow-up Study in New Terminal Hair among Pregnant Women

作　　者：赵晓苗[1] 杨亚波[1] 韩杨[2] 杜涛[1] 谭旻 陈晓莉[1] 杨冬梓[1] ZHAO Xiao-miao YANG Ya-bo HAN Yang DU Tao TAN Min CHEN Xiao-li YANG Dong-zi(Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China Department of Obstetrics and Gynecology, The First Hospital of Sun Yat-sen University, Guangzhou 510080, China)

机构地区：[1]中山大学孙逸仙纪念医院妇产科,广东广州510120 [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）》2017年第5期699-704,共6页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：国家自然科学基金(81100402;81471425;81370680)

摘　　要：【目的】通过改良(mFG)评分系统评价妇女妊娠期间身体不同部位新生体毛的生长状况;分析不同部位的多毛评分对诊断多毛的价值,对mFG评分系统进行优化。【方法】收集自2014年7月至10月在中山大学孙逸仙纪念医院进行产前检查的孕妇43例,于孕前、孕5~9、10~14、15~20和21~24周进行随访,并再纳入15~24周的72例孕妇进行观察。所有孕妇在每次观察时均采用mFG评分系统进行多毛评分,同时采用高效液相色谱串联质谱(LC-MS/MS)法检测血清总睾酮水平。比较不同孕周睾酮水平及mFG分值,总体间的比较采用单因素方差分析法,两两比较采用LSD法。作受试者工作特征曲线(ROC)分析各个部位的终毛生长对多毛症的诊断效能,同时通过Logistics回归分析出对多毛诊断有显著性意义的部位。再将这些部位组合、分值相加命名为简化FG评分(s FG),ROC曲线评估s FG评分系统对多毛诊断的敏感性和特异性,获得诊断界值。【结果】在43例从孕前随访到中孕的孕妇中,孕前的总睾酮为(1.09±0.59)nmol/L,在孕5~9、10~14和15~20周分别为(1.13±0.40)、(1.28±0.38)、(1.83±0.63)和(1.82±0.52)nmol/L,各组与孕前总睾酮相比,差异有统计学意义(P<0.05)。9个部位的多毛评分中,mFG总分在各组中分别为:1.65±0.60、2.30±0.45、3.60±0.68、4.20±0.41和4.40±0.77。身体不同部位新生终毛出现的先后顺序依次为:上腹部、下腹部、下背部、上唇、大腿、上背、胸部、上臂和下颌。纳入15~24周观察的72例孕妇、共115例孕妇中,ROC曲线分析显示,各个部位对多毛(mFG≥5)诊断的价值由高到低依次为,上唇>下背>大腿>下腹>上臂>上背>胸/上腹>下颌。而排在前4位的部位,即上唇、下背、大腿和下腹对多毛诊断的贡献度最为显著,其ROC曲线下面积分别为0.779、0.728、0.675和0.626。进一步Logistics回归分析也显示,对诊断多毛最有价值的部位是上唇、下背、大腿�【Objective】To evaluate the terminal hair growth of different body positions among in pregnant women,analyze the contribution of each area to the diagnosis to hirsutism,to improve the mFG scoring system. 【Method】Pregnant women aged 20 ~ 41 years,with normal range of total testosterone levels and non-hirsute were recruited at their prenatal care in Sun Yat-sen Memorial Hospital,Sun Yat-sen University. They were followed up before pregnancy,at the 5^th and the 9^th week,the 10^th and the 14^th week,the 15^th and the 20^th week,the 21^th and the 24^th week of gestation. Then 72 more cases of pregnant women were recruited and followed up at 15 ~ 24^th week. At each time of followed up,their total testosterone（TT）levels was examined by liquid chromatography tandemmass spectrometry（LC/MS-MS）and terminal hair growth were assessed by mFG score. Significant difference procedure least（LSD）analysis of variance was used to compare the levels of testosterone and mFG score in different gestational weeks. Receiver operating characteristics（ROC）analysis and logistics analysis were conducted to evaluate the contributory strength of hair growth in each body position for the diagnosis of hirsutism. The scores in the body area which made a significant contribution to the total were summed up and termed the simplified mFG score（s FG score）. Following,the s FG scores were subjected to ROC analysis to determine the threshold that would maximize both the sensitivity and specificity of the measure to accurately distinguish hirsute from non-hirsute patients.【Results】Among the forty three pregnant women who were followed-up from before pregnancy to 24 thweek,the mean±SD for TT was（1.09 ± 0.59）nmol/L before pregnancy,and（1.13 ± 0.40）,（1.28 ± 0.38）,（1.83 ± 0.63）,（1.82 ± 0.52）nmol/L for 5 ~ 9^th,10 ~14^th,15 ~ 20 thweek,and the mFG score was 1.65 ± 0.60,2.30 ± 0.45,3.60 ± 0.68,4.20 ± 0.41 and 4.40 ± 0.77,respectively.The order of the facial and body sites presented with new termina

关 键 词：孕妇 改良Ferriman-Gallwey评分 多毛症 雄激素增多 

分 类 号：R711[医药卫生—妇产科学]