血清AMH、adropin和DHEAS表达与PCOS患者发病的相关性及对疗效的预测价值分析  

The correlation between serum AMH,adropin and DHEAS expression with the onset of PCOS patients and its predictive value for treatment efficacy analysis

作　　者：王海青 白云 王苓 宋志娇 WANG Haiqing;BAI Yun;WANG Ling;SONG Zhijiao(Department of Women's Health,Children's Hospital of Shanxi/Women Health Center of Shanxi,Shanxi Taiyuan 030013,China;Department of Health Care,Children's Hospital of Shanxi/Women Health Center of Shanxi,Shanxi Taiyuan 030013,China)

机构地区：[1]山西省儿童医院/山西省妇幼保健院妇女保健科,山西太原030013 [2]山西省儿童医院/山西省妇幼保健院保健部,山西太原030013

出　　处：《中国妇幼健康研究》2024年第4期50-55,共6页Chinese Journal of Woman and Child Health Research

基　　金：山西省儿童医院课题基金(2021011)。

摘　　要：目的探讨血清抗缪勒管激素(AMH)、adropin(AD)和硫酸脱氢表雄酮(DHEAS)表达与多囊卵巢综合征(PCOS)患者发病的相关性及对疗效的预测价值。方法选取2020年9月至2022年5月在我院接受二甲双胍片+优思悦治疗的PCOS患者62例为PCOS组,另选取同时期来我院检查健康者50例为对照组,测定两组血清AMH、AD、DHEAS水平,分析与PCOS发生的关系及对疗效的预测价值。结果研究发现PCOS组胰岛素抵抗指数(HOMA-IR)和血清雄烯二酮(ASD)、睾酮(T)、黄体生成素(LH)、AMH、DHEAS水平明显高于对照组,AD水平明显低于对照组(t值分别为7.808、12.701、13.121、16.717、11.659、17.476和25.391,P<0.05)。多因素Logistic回归分析显示,HOMA-IR(OR=2.640,95%CI:2.439~9.284)、AMH(OR=2.635,95%CI:1.458~4.763)、DHEAS(OR=1.087,95%CI:1.033~1.143)为PCOS发病独立危险因素,AD(OR=0.505,95%CI:0.286~0.891)为保护因素(P<0.05)。有效组血清AMH、DHEAS水平明显低于无效组,AD水平明显高于无效组(t值分别为5.049、5.641和5.704,P<0.05)。受试者工作特征(ROC)曲线显示,血清AMH+AD+DHEAS水平[曲线下面积(AUC)=0.909,95%CI:0.804~0.969]预测PCOS患者疗效的敏感度、特异度、准确度均高于AMH(AUC=0.795,95%CI:0.668~0.889)、AD(AUC=0.765,95%CI:0.635~0.866)、DHEAS(AUC=0.750,95%CI:0.619~0.854)单独预测。结论PCOS患者血清AMH、DHEAS、AD联合检测可能为预测临床疗效和明确病因提供佐证。Objective To investigate the correlation between serum anti-Müllerian hormone(AMH),adropin(AD)and dehydroepiandrosterone sulphate(DHEAS)expression with the onset of polycystic ovary syndrome(PCOS)patients and its predictive value for treatment efficacy.Methods 62 PCOS patients who received metformin tablets combined with drospirenone and ethinylestradiol tablets(Ⅱ)treatment at our hospital from September 2020 to May 2022 were selected as the PCOS group,and 50 healthy individuals who underwent examinations at our hospital during the same period were selected as the control group.The serum AMH,AD and DHEAS levels of the two groups were measured to analyze their relationship with PCOS onset and the predictive value for treatment efficacy.Results The study found that in the PCOS group,the HOMA-insulin resistance index(HOMA-IR)and serum androstenedione(ASD),testosterone(T),luteinizing hormone(LH),AMH and DHEAS levels were significantly higher than those in the control group,and AD levels were significantly lower than those in the control group(t=7.808,12.701,13.121,16.717,11.659,17.476,and 25.391,respectively,all P<0.05).Multivariate logistic regression analysis showed that HOMA-IR(OR=2.640,95%CI:2.439-9.284),AMH(OR=2.635,95%CI:1.458-4.763)and DHEAS(OR=1.087,95%CI:1.033-1.143)were independent risk factors for PCOS onset,while AD(OR=0.505,95%CI:0.286–0.891)was a protective factor(P<0.05).Serum AMH and DHEAS levels in the effective treatment group were significantly lower than those in the ineffective group,and AD levels were significantly higher than those in the ineffective group(t=5.049,5.641,and 5.704,respectively,all P<0.05).The receiver operating characteristic(ROC)curves analysis showed that the sensitivity,specificity and accuracy of predicting treatment efficacy in PCOS patients using serum AMH+AD+DHEAS levels[area under the curve(AUC)=0.909,95%CI=0.804-0.969]were higher than those of AMH alone(AUC=0.795,95%CI:0.668-0.889),AD alone(AUC=0.765,95%CI:0.635-0.866),and DHEAS(AUC=0.750,95%CI:0.619-0.854).Conclus

关 键 词：多囊卵巢综合征 抗缪勒管激素 adropin蛋白 硫酸脱氢表雄酮 疗效 预测价值 

分 类 号：R173[医药卫生—妇幼卫生保健]