PCOS患者血清血管生成素样蛋白2、4水平与卵巢间质血流动力学的关系  

Changes of serum angiopoietin-like protein 2 and 4 levels and their relationship with ovarian interstitial hemodynamics in patients with PCOS

作　　者：赵芳园[1] 邹红[1] 时思毛[2] 徐芳[2] 左冬冬[3] ZHAO Fangyuan;ZOU Hong;SHI Simao;XU Fang;ZUO Dongdong(Department of Ultrasound Medicine,the First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine,Harbin 150040,China;Department of Gynaecology,the First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine,Harbin 150040,China;Preventive Medicine Centre,the First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine,Harbin 150040,China)

机构地区：[1]黑龙江中医药大学附属第一医院超声医学科,150040 [2]黑龙江中医药大学附属第一医院妇科,150040 [3]黑龙江中医药大学附属第一医院医院前治疗中心,150040

出　　处：《天津医药》2023年第9期988-992,共5页Tianjin Medical Journal

基　　金：黑龙江省中医药管理局科研项目(2018-064)。

摘　　要：目的探讨多囊卵巢综合征(PCOS)患者血清血管生成素样蛋白2、4(Angptl2、Angptl4)与卵巢间质血流动力学的关系。方法选取123例PCOS患者(PCOS组)及41例健康志愿者(对照组),比较2组血清Angptl2、Angptl4水平及卵巢间质收缩期最大血流速度(PSV)、搏动指数(PI)、阻力指数(RI);分析Angptl2、Angptl4与PSV、PI、RI及PCOS的关系及两者对PCOS的预测价值。结果PCOS组左右侧卵巢间质PI、RI均低于对照组,PSV高于对照组(P<0.05)。Pearson分析显示,PCOS患者血清Angptl2、Angptl4与左右侧卵巢间质PSV呈正相关,与PI、RI呈负相关(P<0.01)。Logistic回归结果显示,高HOMA-IR(OR=1.921,95%CI:1.017~4.154)、高BMI(OR=1.459,95%CI:1.085~3.220)、高Angptl2(OR=2.625,95%CI:1.330~6.324)、高Angptl4(OR=3.543,95%CI:1.915~8.147)是影响PCOS发生的危险因素(P<0.05)。受试者工作特征(ROC)曲线显示,血清Angptl2、Angptl4单独应用时,预测PCOS的AUC(95%CI)为0.747(0.661~0.821)、0.769(0.685~0.841),低于两者联合应用的0.879(0.793~0.921,P<0.05)。结论血清Angptl2、Angptl4在PCOS患者中异常升高,与卵巢间质血流动力学相关,且两者与PCOS发生密切相关,可作为评估PCOS的参考指标。Objective To investigate changes of serum Angptl2 and Angptl4 levels in patients with polycystic ovary syndrome(PCOS)and their relationship with ovarian interstitial hemodynamics.Methods A total of 123 PCOS patients(the PCOS group)and 41 healthy volunteers(the control group)were selected.The serum Angptl2 and Angptl4 levels,the peak systolic velocity(PSV),pulsation index(PI)and resistance index(RI)of ovarian interstitial were compared between the two groups.The relationship between Angptl2,Angptl4,PSV,PI,RI and PCOS and their predictive value to PCOS were analyzed.Results The PI and RI values of left and right ovarian interstitial were lower in the PCOS group than those in the control group,and PSV values were higher than those in the control group(P<0.05).Pearson analysis showed that serum Angptl2 and Angptl4 were positively correlated with PSV of left and right ovarian interstitial,and negatively correlated with PI and RI of left and right ovarian interstitial in patients with PCOS(P<0.01).Logistic regression results showed that high HOMA-IR(OR=1.921,95%CI:1.017-4.154),high BMI(OR=1.459,95%CI:1.085-3.220),high Angptl2(OR=2.625,95%CI:1.330-6.324),high Angptl4(OR=3.543,95%CI:1.915-8.147)levels were related factors affecting the occurrence of PCOS(P<0.05).Receiver operating characteristic curve(ROC)showed that the AUC(95%CI)of predicted PCOS were 0.747(0.661-0.821)and 0.769(0.685-0.841)when serum Angptl2 and Angptl4 were used alone.It was lower than that of 0.879(0.793-0.921,P<0.05)for the combined application.Conclusion The abnormal levels of serum Angptl2 and Angptl4 in PCOS patients are related to the hemodynamics of ovarian interstitial,and they are closely related to the occurrence of PCOS,which can be used as reference indexes for the evaluation of PCOS.

关 键 词：多囊卵巢综合征 卵巢间质 血流动力学 血管生成素样蛋白2 血管生成素样蛋白4 

分 类 号：R711.75[医药卫生—妇产科学]