论文部分内容阅读
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(P<0.05)。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(P>0.05)。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。
Objective To investigate the effects of inhibin B (INHB), anti-Müllerian hormone (AMH) and various endocrine parameters in patients with and without polycystic ovary syndrome (PCOS) The clinical value of INHB and AMH in predicting PCOS and the characteristics of endocrine indexes in both groups were compared. Methods From September 2016 to May 2017, 567 PCOS patients attending the Department of Endocrinology, Beijing Maternity and Child Hospital, Capital Medical University, were selected as the study group. The age, primary infertility and secondary infertility patients 53 cases of normal physical examination as a control group. All subjects were measured for height, body weight, fasting blood levels of INHB, AMH, follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2) (testosterone, T), analysis of PCOS group and control group serum INHB, AMH mass concentration and endocrine index characteristics. Results The levels of serum AMH, LH, T and body mass index (BMI) in PCOS group were significantly higher than those in control group, but E2 and FSH / LH were lower than those in control group P <0.05). The concentration of INHB in PCOS group was higher than that in control group, and FSH was lower than that in control group. There was no significant difference between two groups (P> 0.05). AMH predicts polycystic ovary syndrome the best cut-off value of 4.84μg / L, the sensitivity was 84.48%, the specificity was 69.81%. INHB predicts the cut-off value of polycystic ovary syndrome is 70.8 ng / L, the sensitivity is 53.97% and the specificity is 67.92%. The combined sensitivity of AMH and INHB (parallel test) in polycystic ovary syndrome is 90.29% , Specificity was 54.92%. Conclusion The cut-off value of PCOS was 4.84 μg / L in AMH, 70.8 ng / L in INHB, and the combined sensitivity of AMH and INHB was higher than that of AMH The prediction of clinical PCOS has very important guiding significance.