2018 年第 5 期 第 13 卷

抗苗勒管激素与多囊卵巢综合征的相关性研究

Correlation between anti-mullerian hormone and polycystic ovary syndrome

作者：邵文王克芳

英文作者：

单位：100029首都医科大学附属北京安贞医院妇产科

英文单位：

关键词：多囊卵巢综合征；抗苗勒管激素；性激素

英文关键词：

• 摘要：

• 目的    分析抗苗勒管激素（AMH）与多囊卵巢综合征（PCOS）的相关性。方法    选取2016年1月至2017年12月首都医科大学附属北京安贞医院妇产科门诊就诊的PCOS患者110例（PCOS组）和健康育龄女性60例（正常育龄组）作为研究对象。分别于月经第2～3天抽取静脉血2 ml，测定2组研究对象血清AMH水平及基础性激素水平。通过Person相关分析血清AMH与黄体生成素（LH）、卵泡刺激素（FSH）、LH/FSH比值、雌二醇及睾酮的关系。借助受试者工作特征曲线分析血清AMH对PCOS的诊断价值。结果    PCOS组患者AMH、LH、LH/FSH比值及睾酮水平明显高于正常育龄组［（7±4）μg/L比（4±3）μg/L、（9.4±5.8）U/L比（4.4±2.4）U/L、（1.4±0.9）比（0.7±0.4）、（0.57±0.22）μg/L比（0.44±0.16）μg/L］，差异均有统计学意义（均P<0.05）。2组FSH、雌二醇水平差异无统计学意义（P>0.05）。PCOS组患者AMH水平与LH、LH/FSH比值以及雌二醇水平呈正相关（r=0.373、0.440、0.247，均P<0.05），与FSH、睾酮水平无明显相关性（P>0.05）。AMH诊断PCOS的受试者工作特征曲线下面积为0.755；最佳诊断切值为6.458 μg/L，诊断PCOS的敏感度为55.5%，特异度为85.0%。结论    PCOS患者的血清AMH水平明显高于健康育龄期女性，且与激素水平有密切的关系，血清AMH水平或将成为一种诊断PCOS的有效手段。

• 【Abstract】Objective    To analyze the correlation between anti-mullerian hormone(AMH) and polycystic ovary syndrome(PCOS). Methods    From January 2016 to December 2017, 110 PCOS patients(PCOS group) and 60 healthy women of reproductive age(normal control group) were enrolled at Beijing Anzhen Hospital, Capital Medical University. Venous blood was sampled on the 2nd-3rd day of menstruation to test serum levels of AMH and sex hormones. Correlations of AMH with luteinizing hormone(LH), follicle-stimulating hormone(FSH), LH/FSH, estradiol and testosterone were tested by Pearson analysis. The value of serum AMH level in diagnosis of PCOS was analyzed by the receiver operating characteristic(ROC) curve. Results    Levels of serum AMH, LH, LH/FSH and testosterone in PCOS group were significantly higher than those in normal control group［（7±4）μg/L vs （4±3）μg/L, （9.4±5.8）U/L vs （4.4±2.4）U/L, （1.4±0.9） vs （0.7±0.4）, （0.57±0.22）μg/L vs （0.44±0.16）μg/L］(P<0.05). Levels of FSH and estradiol had no significant differences between groups(P>0.05). Pearson analysis showed that AMH level was positively correlated with LH, LH/FSH and estradiol(r=0.373, 0.440, 0.247， P<0.05). The area under the ROC curve of AMH in diagnosis of PCOS was 0.755; the cut-off value was 6.458 μg/L; the sensitivity was 55.5%; the specificity was 85.0%. Conclusions    Serum AMH level in PCOS patients is significantly higher than that in healthy women, and there is a sighificart relation between AMH and hormone level. Serum AMH level may be a new index in diagnosis of PCOS.

  【Key words】Polycystic ovary syndrome;Anti-mullerian hormone;Sex hormone

  【Fund program】National Natural Science Foundation of China(81770468); "Yangfan" Clinical Medical Development Project of Beijing Municipal Aduinistration of Hospitals（XMLX201823）; Clinical Research Fund of Wu Jieping Medical Foundation(320.6750.17016)