抗米勒管激素与黄体生成素/促卵泡刺激素比值联合检测对多囊卵巢综合征的诊断价值  

The diagnostic value of serum anti-Müllerian hormone combined with LH/FSH for polycystic ovary syndrome

作　　者：谭珊 蓝叶彬[1] 张小薇[1] 郑颖[1] TAN Shan;LAN Yebin;ZHANG Xiaowei;ZHENG Ying(Department of Clinical Laboratory,Lishui Central Hospital in Zhejiang Province,Lishui 323000,China)

机构地区：[1]浙江省丽水市中心医院检验科,丽水323000

出　　处：《浙江医学教育》2023年第3期188-192,共5页Zhejiang Medical Education

摘　　要：目的探讨女性血清抗米勒管激素(anti-Müllerian hormone,AMH)与黄体生成素/促卵泡刺激素(luteinizing hormone/follicle stimulating hormone,LH/FSH)联合检测对多囊卵巢综合征(polycystic ovary syndrome,PCOS)的诊断价值。方法回顾性收集2019年1月至2020年12月在浙江省丽水市中心医院诊治的96例PCOS患者和同期进行常规健康体检的76名女性为研究对象,将前者设为试验组,后者设为对照组。采用化学发光法检测试验组患者和对照组体检者血清中的AMH和FSH、LH、雌二醇(estradiol,E2)和睾酮(testosterone,T)水平并进行比较。使用受试者工作特征曲线(receiver operating characteristic,ROC)比较各项目单独和联合检测对PCOS的诊断价值。结果与对照组体检者相比,试验组患者AMH、T水平和LH/FSH比值均有所升高[(7.52±4.02)ng/mL vs.(3.92±2.27)ng/mL,(1.11±6.28)ng/mL vs.(0.35±0.15)ng/mL,2.08±1.89 vs.1.38±0.96],其差异均具有统计学意义(均P<0.05)。ROC结果表明,在单项指标的诊断中,AMH单项检测的曲线下面积(AUC=0.868)明显高于LH、T和LH/FSH单项检测的曲线下面积(0.868 vs.0.647、0.868 vs.0.714、0.868 vs.0.644),其差异均具有统计学意义(均P<0.05)。AMH诊断PCOS的灵敏度为71.87%,明显高于LH和LH/FSH的灵敏度、低于T的灵敏度;AMH诊断PCOS的特异度为90.79%,高于LH、T和LH/FSH单独检测的特异度。AMH与各种性激素联合检测结果表明,AMH+LH/FSH联合检测的曲线下面积(AUC=0.886),高于任意其他组合联合检测的曲线下面积,其差异均具有统计学意义(均P<0.05)。结论在常规性激素检测中,LH/FSH比值同时联合抗米勒管激素对多囊卵巢综合征进行检测,具有更高的诊断价值,有助于提高临床诊断效能。Objective To explore the diagnostic value of combined detection of serum anti-Müllerian hormone(AMH)and luteinizing hormone/follicle-stimulating hormone(LH/FSH)in women with polycystic ovary syndrome(PCOS).Methods A total of 96 patients with PCOS who were diagnosed and treated in Lishui Central Hospital in Zhejiang Province from January 2019 to December 2020 were set as the experimental group,while 76 women who underwent routine physical examination during the same period were set as the control group.Chemiluminescence method was used to detect and compare the serum levels of AMH,follicle-stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2)and testosterone(T)in the experimental group and the control group.Receiver operating characteristic(ROC)curves were used to compare the diagnostic value of individual and combined tests for PCOS.Results Compared with those in the control group,the levels of AMH,T and LH/FSH in the experimental group were significantly increased[(7.52±4.02)ng/mL vs.(3.92±2.27)ng/mL,(1.11±6.28)ng/mL vs.(0.35±0.15)ng/mL,2.08±1.89 vs.1.38±0.96](all P<0.05).The ROC results showed that in the diagnosis of a single index,the area under the curve of AMH single test(AUC=0.868)was significantly higher than that of LH,T and LH/FSH single test(0.868 vs.0.647,0.868 vs.0.714,0.868 vs.0.644),the difference was statistically significant(all P<0.05).The sensitivity of AMH in diagnosing PCOS was 71.87%,which was significantly higher than that of LH and LH/FSH and lower than that of T;the specificity was 90.79%,which was higher than that of LH,T and LH/FSH alone.The results of the combined detection of AMH and various sex hormones showed that the area under the curve of the combined detection of AMH+LH/FSH(AUC=0.886)was higher than the area under the curve of the combined detection of any other combination,and the difference was statistically significant(all P<0.05).Conclusions In routine sex hormone detection,LH/FSH ratio combined with anti-Müllerian hormone to detect polycystic ovary syndrome

关 键 词：多囊卵巢综合征 抗米勒管激素 性激素 联合检测 诊断价值 

分 类 号：R711.75[医药卫生—妇产科学]