性激素七项抗苗勒管激素联合检测诊断不孕症的准确率及临床意义  

Accuracy of the combined seven items of sex hormones and AMH test in the diagnosis of infertility and its clinical significance

作　　者：石绒 寇卉 马勤利 马琳枝 Shi Rong;Kou Hui;Ma Qinli;Ma Linzhi(Reproductive Center,Northwest Women and Children′s Hospital,Xi′an710004,China)

机构地区：[1]西北妇女儿童医院生殖中心,西安710004

出　　处：《山西医药杂志》2024年第17期1306-1309,共4页Shanxi Medical Journal

摘　　要：目的探究性激素七项、抗苗勒管激素(AMH)联合检测诊断不孕症的准确率及指导临床的意义。方法回顾性分析病例资料,选择2021年1月至2022年1月在我院接受治疗的不孕患者2050例为研究对象,纳为不育组。同期选择健康妇女1800名为健康对照组,采集2组受检者月经期2~4 d静脉血,采用BECKMAN DXI-800全自动化学发光仪分析仪检测受检者血清黄体生成素(LH)、泌乳素(PRL)、睾酮(T)、孕酮(P)、卵泡刺激素(FSH)、雌二醇(E_(2))、促甲状腺激素(TSH)、AMH水平,采用受试者工作特征(ROC)曲线评估性激素七项、AMH诊断不孕症价值。随访1年,根据不孕症患者做助孕治疗受孕结果分为受孕成功组(1271例)、受孕失败组(779例),比较2组患者性激素及AMH水平变化。结果2组患者血清T、P、E2水平差异无统计学意义(P>0.05);不孕组患者血清LH、TSH、FSH、PRL水平高于健康对照组(P<0.05)。不孕组患者血清AMH水平低于健康对照组(P<0.05)。ROC曲线显示,LH、TSH、FSH、PRL、AMH、性激素指标诊断不孕症的曲线下面积(AUC)分别为0.768、0.778、0.745、0.671、0.715、0.816。性激素指标+AMH诊断不孕症的AUC为0.869。受孕失败组患者LH偏高、TSH偏高、FSH偏高、PRL偏高、AMH偏低比例高于受孕成功组,手术+激素治疗比例低于受孕成功组(P<0.05)。结论不孕症患者血清LH、TSH、FSH、PRL、AMH水平明显异常表达,在诊断不孕症患者方面具有一定价值,且联合诊断价值最佳,另外,在临床手术治疗的同时辅助激素治疗调控LH、TSH、FSH、PRL、AMH水平变化有助于提高受孕成功率,改善患者预后情况。Objective To explore the accuracy and clinical significance of the combined detection of seven sexual hormones and anti-Mullerian hormone(AMH)in the diagnosis of infertility.Methods A retrospective analysis of case data was conducted,and 2050 infertile patients who received treatment in our hospital from January 2021 to January 2022 were selected as the study subjects and included in the infertility group.In the same period,1800 healthy women were selected as the healthy control group.The venous blood of the subjects in the two groups was collected from 2~4 days during the menstrual period.The levels of serum Luteinizing hormone(LH),prolactin(PRL),testosterone(T),progesterone(P),follicle-stimulating hormone(FSH),estradiol(E_(2)),thyroid-stimulating hormone(TSH),and AMH were measured by the BECKMAN DXI-800 automatic chemiluminescence analyzer.The diagnostic value of seven items of sex hormones and AMH in infertility was evaluated using the receiver operating characteristic(ROC)curve.The infertility patients were followed up for 1 year,and divided into the successful pregnancy group(n=1271)and failed pregnancy group(n=779)based on the results of assisted pregnancy treatment.The changes in sexual hormones and AMH levels between the two groups of patients were compared.Results There was no statistically significant difference in serum T,P,and E2 levels between the two groups(P>0.05).The serum LH,TSH,FSH,and PRL levels in the infertile group were significantly higher than those in the healthy control group(P<0.05).The serum AMH levels in the infertile group were significantly lower than those in the healthy control group(P<0.05).The receiver operating characteristic showed that the area under the curve(AUC)of LH,TSH,FSH,PRL,AMH,and sex hormone indicators in the diagnosis of infertility were 0.768,0.778,0.745,0.671,0.715,and 0.816,respectively.The AUC for diagnosing infertility with sex hormone markers and AMH is 0.869.The proportion of patients with high LH,high TSH,high FSH,high PRL,and low AMH in the failed-to-conce

关 键 词：性腺甾类激素 抗苗勒管激素 不育 女性 准确率 

分 类 号：R711.6[医药卫生—妇产科学]