改良简化的Ferriman-Gallwey评分系统在中国女性多毛评价中的应用分析

发布时间：2018-06-05 02:44

  本文选题：孕妇 + 改良Ferriman-Gallwey评分　； 参考：《中山大学学报(医学科学版)》2017年05期

【摘要】：【目的】通过改良(mFG)评分系统评价妇女妊娠期间身体不同部位新生体毛的生长状况;分析不同部位的多毛评分对诊断多毛的价值,对mFG评分系统进行优化。【方法】收集自2014年7月至10月在中山大学孙逸仙纪念医院进行产前检查的孕妇43例,于孕前、孕5~9、10~14、15~20和21~24周进行随访,并再纳入15~24周的72例孕妇进行观察。所有孕妇在每次观察时均采用mFG评分系统进行多毛评分,同时采用高效液相色谱串联质谱(LC-MS/MS)法检测血清总睾酮水平。比较不同孕周睾酮水平及mFG分值,总体间的比较采用单因素方差分析法,两两比较采用LSD法。作受试者工作特征曲线(ROC)分析各个部位的终毛生长对多毛症的诊断效能,同时通过Logistics回归分析出对多毛诊断有显著性意义的部位。再将这些部位组合、分值相加命名为简化FG评分(s FG),ROC曲线评估s FG评分系统对多毛诊断的敏感性和特异性,获得诊断界值。【结果】在43例从孕前随访到中孕的孕妇中,孕前的总睾酮为(1.09±0.59)nmol/L,在孕5~9、10~14和15~20周分别为(1.13±0.40)、(1.28±0.38)、(1.83±0.63)和(1.82±0.52)nmol/L,各组与孕前总睾酮相比,差异有统计学意义(P0.05)。9个部位的多毛评分中,mFG总分在各组中分别为:1.65±0.60、2.30±0.45、3.60±0.68、4.20±0.41和4.40±0.77。身体不同部位新生终毛出现的先后顺序依次为:上腹部、下腹部、下背部、上唇、大腿、上背、胸部、上臂和下颌。纳入15~24周观察的72例孕妇、共115例孕妇中,ROC曲线分析显示,各个部位对多毛(mFG≥5)诊断的价值由高到低依次为,上唇下背大腿下腹上臂上背胸/上腹下颌。而排在前4位的部位,即上唇、下背、大腿和下腹对多毛诊断的贡献度最为显著,其ROC曲线下面积分别为0.779、0.728、0.675和0.626。进一步Logistics回归分析也显示,对诊断多毛最有价值的部位是上唇、下背、大腿和下腹部。将这4个部位组合诊断多毛,以3为诊断界值时诊断的敏感性和特异性最佳。【结论】孕24周前,孕妇的mFG评分随着妊娠的进展逐步增加。上唇、下背、大腿和下腹是对多毛诊断有显著意义的部位,有可能作为代替mFG评分的简化组合,用以诊断多毛;诊断界值为sFG≥3分。
[Abstract]:[objective] to evaluate the growth status of newborn hair in different parts of the body of women during pregnancy by modified mFG scoring system, and to analyze the value of hairy score of different parts in the diagnosis of hirsutism. The mFG scoring system was optimized. [methods] Forty-three pregnant women who underwent prenatal examination in Sun Yat-sen Memorial Hospital, Sun Yat-sen Memorial University, Sun Yat-sen University, from July to October 2014, were followed up for 24 weeks before pregnancy. 72 pregnant women of 15 ~ 24 weeks were observed. All pregnant women were evaluated with mFG scoring system and serum total testosterone was measured by HPLC tandem mass spectrometry (HPLC / MS / MS). The testosterone levels and mFG scores in different gestational weeks were compared. Univariate analysis of variance and LSD method were used to compare the population. The diagnostic efficacy of terminal hair growth on hypertrichoresis was analyzed by using the operating characteristic curve of the subjects. At the same time, Logistics regression analysis was used to identify the parts with significant significance in the diagnosis of hirsutism. Then the combination of these sites was added as simplified FG score / s FGG / ROC curve to evaluate the sensitivity and specificity of the s FG scoring system for the diagnosis of hirsutism. [results] among 43 pregnant women who were followed up from pre-pregnancy to middle pregnancy, The total testosterone before pregnancy was 1.09 卤0.59nmol / L, 1.13 卤0.40nmol / L and 1.82 卤0.52nmol / L, respectively, at the week of 5 weeks (1.13 卤0.40) and 1.82 卤0.52 (nmol / L), respectively. The total score of MFG in 9 parts of the pregnancy group was 1.65 卤0.602.30 卤0.453.60 卤0.684.20 卤0.684.20 卤0.41 and 4.40 卤0.777.The results showed that there was no significant difference between the two groups in total testosterone before pregnancy (1.09 卤0.59 nmol / L), and the total score of mFG was 1.65 卤0.602.30 卤0.453.60 卤0.684.60 卤0.684.20 卤0.41 and 4.40 卤0.77 respectively. The order of appearance of new hair in different parts of body is upper abdomen, lower back, upper lip, thigh, upper back, chest, upper arm and mandible. The ROC curve analysis of 115 cases of 72 pregnant women who were observed 24 weeks after 15 weeks showed that the value of each part in diagnosis of hyperhirhidrosis MFG 鈮，

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