多囊卵巢综合征患者血清AMH、TNF-α、T、DHEA-S的水平及临床意义  

Detection of serum AMH, TNF-alpha, T, and DHEA-S in patients with polycystic ovary syndrome and its clinical significance

作　　者：翟庆娜[1] 刘芹兰[1] 路瑞静 袁康凯[1] 张修发[1] 王丰[1] ZHAI Qing-na;LIU Qin-lan;LU Rui-jing;YUAN Kang-kai;ZHANG Xiu-fa;WANG Feng(Department of Clinical Laboratory,Maternal and Child Health Hospital of Bao'an District,Shenzhen 518102,Guangdong,CHINA)

机构地区：[1]深圳市宝安区妇幼保健院检验科,广东深圳518102

出　　处：《海南医学》2020年第9期1100-1102,共3页Hainan Medical Journal

基　　金：广东省深圳市宝安区科技计划项目(编号:2016cx237)。

摘　　要：目的探讨多囊卵巢综合征(PCOS)患者血清抗苗勒管激素(AMH)、肿瘤坏死因子-α(TNF-α)、睾酮(T)、硫酸脱氢表雄酮(DHEA-S)水平及临床意义,为患者的临床诊疗提供指导。方法选择2017年8月至2019年9月在深圳市宝安区妇幼保健院治疗的220例PCOS患者为观察组,并选择我院同期体检健康人群180例作为对照组。检测两组受检者的血清AMH、TNF-α、T、DHEA-S表达水平,计算各指标诊断PCOS的曲线下面积(AUC)及95%置信区间(95%CI),分析其诊断价值。结果观察组患者的AMH、TNF-α、T及DHEA-S水平分别为(8.74±4.27) pg/mL、(271.56±130.86) pg/mL、(0.72±0.26) nmoI/L、(8.17±3.23)μg/dL、(3.25±1.54) pg/mL,明显高于对照组的(5.46±2.19) pg/mL、(212.64±99.25) pg/mL、(0.46±0.18) nmoI/L、(6.69±2.78)μg/dL、(1.42±0.63) pg/mL,差异均有统计学意义(P<0.05);血清AMH诊断PCOS的AUC为0.754,95%CI为0.705~0.802;血清TNF-α诊断PCOS的AUC为0.629,95%CI为0.575~0.683;血清T诊断PCOS的AUC为0.815,95%CI为0.774~0.856;血清DHEA-S诊断PCOS的AUC为0.654,95%CI为0.601~0.70;AMH+TNF-α+T+DHEA-S诊断PCOS的AUC为0.892,95%CI为0.861~0.924;AMH+TNF-α+T+DHEA-S联合检测诊断PCOS的AUC明显高于单独检测,差异有统计学意义(P<0.05);AMH+TNF-α+T+DHEA-S联合检测的特异度及准确度均明显高于单独检测,差异均有统计学意义(P<0.05)。结论 PCOS血清AMH、TNF-α、T、DHEA-S水平均明显升高,四项指标联合检测对PCOS有较高的诊断价值,且各指标的变化有助于指导临床诊疗。Objective To explore the levels of anti-Müllerian hormone(AMH), tumour necrosis factor-α(TNF-alpha), testosterone(T) and dehydroepiandrosterone sulfate(DHEA-S) in patients with polycystic ovary syndrome and its clinical significance. Methods A total of 220 patients with polycystic ovary syndrome(PCOS), who received the treatment at the Maternal and Child Health Hospital of Bao’an District, Shenzhen from August 2017 to September2019, were enrolled into the observation group, and 180 healthy people in at the Maternal and Child Health Hospital of Bao’an District, Shenzhen were selected as the control group. The serum levels of AMH, TNF-α, T, and DHEA-S were detected in two groups of subjects, and the area under the curve(AUC) and 95% confidence interval(95% CI) for the diagnosis of PCOS were calculated for each indicator, and their diagnostic value was analyzed. Results The levels of AMH,TNF-α, T and DHEA-S in the observation group were(8.74±4.27) pg/m L,(271.56±130.86) pg/m L,(0.72±0.26) nmol/L,(8.17±3.23) μg/d L,(3.25±1.54) pg/m L, respectively, which were significant higher than corresponding(5.46±2.19) pg/m L,(212.64±99.25) pg/mL,(0.46±0.18) nmol/L,(6.69±2.78) μg/dL,(1.42±0.63) pg/mL in the control group(all P<0.05).The AUC of serum AMH in the diagnosis of PCOS was 0.754, and 95% CI was 0.705-0.802;the AUC of serum TNF-α was 0.629, 95% CI was 0.575-0.683;the AUC of serum T was 0.815, 95% CI was 0.774-0.856;the AUC of DHEA-S was 0.654 and 95% CI was 0.601-0.70;the AUC of AMH+TNF-α+T+DHEA-S was 0.892 and 95% CI was0.861-0.924;the AUC of AMH+TNF-α+T+DHEA-S was significantly higher than that of single test(P<0.05);the specificity and accuracy of AMH + TNF-α + T + DHEA-S were significantly higher than that of single test(P<0.05).Conclusion The levels of serum AMH, TNF-α, T, and DHEA-S in PCOS are significantly increased. The combined detection of the four indicators has higher diagnostic value for PCOS, and the changes in each indicator were helpful to guide clinical diagnosis and treatment.

关 键 词：多囊卵巢综合征 抗苗勒管激素 肿瘤坏死因子-α 睾酮 硫酸脱氢表雄酮 

分 类 号：R442.8[医药卫生—诊断学]