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目的:利用液相色谱-质谱联用(LC-MS)方法和化学发光免疫分析法测定不同临床类型PCOS患者的血清雄激素水平,分析中国PCOS女性的高雄激素血症的生化特点。方法:纳入有排卵障碍和多囊卵巢的PCOS患者149例,根据血清睾酮(T)和硫酸脱氢表雄酮(DHEAS)值及F-G多毛评分情况分为两组:高雄组55例,非高雄组94例。同期选取输卵管性不孕患者82例作为对照组。化学发光法测定性激素结合球蛋白(SHBG)水平,计算游离雄激素指数(FTI)。LC-MS法测定各组血清睾酮、雄烯二酮(AD)和脱氢表雄酮(DHEA)。结果:高雄组的血清T水平及FTI值显著高于非高雄组及对照组(P<0.05),非高雄组高于对照组(P<0.05);高雄组、非高雄组的DHEAS及AD水平均高于对照组(P<0.05);3组的DHEA水平比较,差异均无统计学意义。结论:血清T、AD、DHEAS及FTI均为诊断PCOS高雄激素血症的敏感指标;T及FTI是PCOS分型(高雄及非高雄)的主要依据;LC-MS和化学发光免疫分析法对PCOS高雄激素血症的诊断具有一致性。
OBJECTIVE: To determine the serum androgen levels of PCOS patients with different clinical types by LC-MS and chemiluminescence immunoassay, and to analyze the biochemical characteristics of hyperandrogenism in Chinese women with PCOS. Methods: One hundred and ninety-nine PCOS patients with ovulation disorder and polycystic ovary were divided into two groups according to serum testosterone (T) and DHEAS and FG hairiness score: 55 cases in Kaohsiung group, Group of 94 cases. In the same period selected 82 patients with tubal infertility as a control group. The chemiluminescence method was used to determine the level of sex hormone binding globulin (SHBG), and the free androgen index (FTI) was calculated. Serum testosterone, androstenedione (AD) and dehydroepiandrosterone (DHEA) were determined by LC-MS. Results: The serum T level and FTI in Kaohsiung group were significantly higher than those in non-Kaohsiung group and the control group (P <0.05), those in non-Kaohsiung group were higher than those in control group (P <0.05) Were higher than the control group (P <0.05); 3 groups of DHEA levels, the difference was not statistically significant. Conclusions: Serum T, AD, DHEAS and FTI are sensitive indexes for the diagnosis of hyperandrogenism in PCOS. T and FTI are the main basis for PCOS typing (Kaohsiung and non-Kaohsiung). LC-MS and chemiluminescence immunoassay Hormone diagnosis of hyperandrogenism consistent.