血清抗苗勒管激素和促卵泡激素水平在多囊卵巢综合征诊断中的价值  

Values of Serum AMH and FSH Levels in Polycystic Ovary Syndrome

作　　者：张静华[1] 许婷姝[1] 董蕊锐 陆牡丹[1] ZHANG Jinghua;XU Tingshu;DONG Ruirui;LU Mudan(Clinical laboratory,Wuxi Maternity and Child Health Care Hospital,Wuxi 214000,Jiangsu,China)

机构地区：[1]无锡市妇幼保健院检验科,江苏无锡214000

出　　处：《贵州医科大学学报》2020年第11期1337-1340,1346,共5页Journal of Guizhou Medical University

基　　金：江苏省自然科学基金(BK20170209)。

摘　　要：目的:分析血清抗苗勒管激素(AMH)和促卵泡激素(FSH)水平对多囊卵巢综合征(PCOS)的诊断价值。方法:106例PCOS患者作为PCOS组、同期92例健康妇女作为对照组,检测2组妇女月经周期血清AMH及FSH水平、PCOS组内不同症状患者血清AMH及FSH水平;建立AMH、FSH单一及联合检测对PCOS患者预测的受试者工作特征曲线(ROC)下面积(AUC),分析AMH、FSH单一指标检测及联合检测预测PCOS的诊断价值。结果:PCOS组患者血清AMH水平明显高于对照组、FSH明显低于对照组,差异有统计学意义(P<0.05);PCOS组中稀少或无排卵、高雄激素血症(HA)、卵巢多囊样改变(PCOM)者基础血清AMH水平明显高于无症状者,FSH水平明显低于无症状者,差异有统计学意义(P<0.05);ROC曲线显示基础血清AMH、FSH单一指标检测及联合检测均对PCOS均具有预测价值,血清AMH对PCOS的临床价值较高,其预测PCOS的最佳临界值为5.5μg/L,此时敏感度和特异度分别为84.5%、70.1%,AUC为0.843,AMH与FSH联合检测PCOS的敏感性和特异度分别为89.8%、72.7%,AUC为0.906。结论:PCOS患者体内AMH、FSH分泌异常,患者血清AMH和FSH水平可作为预测PCOS的指标,两项指标联合检测的价值更高。Objective:To analyze the diagnostic values of serum anti-Müllerian hormone(AMH)and follicle-stimulating hormone(FSH)levels for patients with polycystic ovary syndrome(PCOS).Methods:One hundred and six PCOS patients were recruited as PCOS group,and 92 healthy women were selected as control group during the same period.Serum AMH and FSH levels of these two groups during their menstrual cycle,and the serum AMH and FSH levels of patients with different symptoms in PCOS group were detected.In addition,the receiver operating characteristic(ROC)curves of PCOS patients predicted by AMH alone,FSH level alone and AMH combined with FSH level were established to analyze their accuracy in diagnosing PCOS patients using area under curve(AUC)values.Results:The serum AMH level of the PCOS group was significantly higher than that of the control group,while the FSH level was significantly lower than that of the control group(P<0.05).PCOS patients with rare or anovulatory,hyperandrogenism(HA),polycystic ovarian morphology(PCOM)had significantly high basal serum AMH levels relative to asymptomatic PCOS patients,in contrast,they had low FSH levels compared to asymptomatic PCOS patients(P<0.05).ROC curve analysis showed that the basal serum AMH alone,FSH alone and their combination had predictive values in diagnosing PCOS.Serum AMH had a high clinical value for PCOS,and its best cut-off value for predicting PCOS was 5.5μg/L,and the sensitivity,specificity and AUC were 84.5%and 70.1%and 0.85 at best cut-off value,respectively.Conclusion:AMH and FSH levels are abnormal in PCOS patients.The serum AMH and FSH levels of patients can be used as indicators to predict PCOS.AMH combined with FSH has high value in predicting PCOS.

关 键 词：血清 多囊卵巢综合征 ROC曲线 抗苗勒氏管激素 促卵泡激素 联合检测 受试者工作曲线 

分 类 号：R446.11[医药卫生—诊断学]