抗苗勒管激素与抑制素B对多囊卵巢综合征的临床预测价值

发布时间：2018-08-21 14:38

【摘要】：目的通过分析多囊卵巢综合征(polycystic ovary syndrome,PCOS)病人与对照组的抑制素B(inhibin B,INHB)、抗苗勒管激素(anti-Müllerian hormone,AMH)及各项内分泌指标,探讨INHB、AMH对PCOS的临床预测价值及比较两组内分泌指标的特点。方法选取2016年9月至2017年5月间在首都医科大学附属北京妇产医院内分泌科就诊的PCOS病人567例为研究组,取同期就诊的年龄、原发不孕与继发不孕病人或正常体检者53例作为对照组。测量所有参与者的身高、体质量,空腹抽血查INHB、AMH、卵泡刺激素(follicle-stimulating hormone,FSH)、黄体生成素(luteinizing hormone,LH)、雌二醇(estradiol,E2)、睾酮(testosterone,T),分析PCOS组与对照组的血清INHB、AMH质量浓度及内分泌指标特点。结果 PCOS组的血清AMH质量浓度、LH、T、体质量指数(body mass index,BMI)均明显高于对照组,E2、FSH/LH低于对照组,且组间差异均有统计学意义(P0.05)。PCOS组的INHB质量浓度高于对照组,FSH低于对照组,组间差异均无统计学意义(P0.05)。AMH预测多囊卵巢综合征的最佳分界值(cut-off)值为4.84μg/L,敏感度为84.48%,特异度为69.81%。INHB预测多囊卵巢综合征的cut-off值为70.8 ng/L,敏感度为53.97%,特异度为67.92%,AMH与INHB联合预测(并联试验)多囊卵巢综合征的敏感度为90.29%,特异度为54.92%。结论 AMH预测PCOS的cut-off值为4.84μg/L,INHB预测PCOS的cut-off值为70.8 ng/L,且AMH与INHB的联合检测(并列试验)敏感度高于AMH单项检测,这对临床PCOS的预测有很重要的指导意义。
[Abstract]:Objective to investigate the clinical predictive value of (polycystic ovary B (inhibin and the characteristics of endocrine indexes in patients with polycystic ovary syndrome (polycystic ovary syndrome) and control group by analyzing the levels of B (inhibin, anti-M 眉 llerian hormone and endocrine indexes in patients with polycystic ovary syndrome (PCOS) and the control group. Methods A total of 567 PCOS patients from September 2016 to May 2017 in the Endocrinology Department of Beijing Obstetrics and Gynecology Hospital affiliated to Capital Medical University were selected as the study group. 53 cases of primary infertility and secondary infertility or normal physical examination were used as control group. The height and body mass of all participants were measured. The serum INHBAMH, follicle-stimulating hormone, luteinizing hormone LH, estradiol E 2 and T were measured. The serum INHBAMH concentration and endocrine parameters in PCOS group and control group were analyzed. Results the serum AMH concentration and body mass index (body mass) in the PCOS group were significantly higher than those in the control group, and the differences were statistically significant (P0.05). The INHB concentration in the PCOS group was significantly higher than that in the control group (P0.05), and the INHB concentration in the PCOS group was significantly higher than that in the control group. There was no significant difference between the two groups (P0.05) .AMH in predicting polycystic ovary syndrome (cut-off) was 4.84 渭 g / L, sensitivity was 84.48. The specificity of 69.81%.INHB in predicting polycystic ovary syndrome (PCOS) was 70.8 ng / L, sensitivity was 53.97, specificity was 67.92AMH combined with INHB. The sensitivity and specificity of predicting polycystic ovary syndrome (PCOS) were 90.29 and 54.92 respectively. Conclusion the cut-off value of PCOS predicted by AMH is 4.84 渭 g / L and the cut-off value of PCOS is 70.8 ng / L, and the sensitivity of AMH combined with INHB is higher than that of AMH, which is very important for clinical PCOS prediction.
【作者单位】：首都医科大学附属北京妇产医院妇科内分泌科;德国图宾根大学妇产医院内分泌与绝经中心;
【基金】：首都临床特色应用研究与成果推广(Z161100000516143) 首都卫生发展科研专项项目(2016-2-2113) 北京市医院管理局临床技术创新项目(XMLX201710) 北京市卫生系统高层次卫生技术人才(学科带头人)(2014-2-016) 国家外国专家局2017年度北京市引进国外技术、管理人才项目(20171100004)~~
【分类号】：R711.75

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