血清黄体生成素与卵泡刺激素比值对卵巢多囊样改变患者确诊多囊卵巢综合征的价值

Preliminary study on the value of ratio of serum luteinizing hormone/follicle-stimulating hormone in diagnosis of polycystic ovarian syndrome among women with polycystic ovary

目的探讨血清黄体生成素（LH）与卵泡刺激素（FSH）的比值对卵巢呈多囊样改变（PCO）患者确诊多囊卵巢综合征（PCOS）的价值，比较欧洲人类生殖与胚胎学会及美国生殖学会的诊断标准（鹿特丹标准）与日本妇产科学会的诊断标准（日本标准）间的差异。方法对195例就诊于南方医科大学南方医院生殖医学中心、阴道B超示PCO的患者，分别按照鹿特丹标准和日本标准进行判别，比较两种标准诊断的PCOS与非PCOS患者之间各项指标间的差异，并通过受试者工作特征（ROC）曲线下面积分析LH、LH／FSH、睾酮等指标在PCOS诊断中的意义；另选择119例非PCO且月经周期正常者作为对照组。结果195例PCO者中，鹿特丹标准确诊PCOS患者144例，非PCOS患者51；日本标准确诊PCOS患者111例，非PCOS患者84例。鹿特丹标准确诊PCOS患者与非PCOS患者的LH／FSH分别为1．59±0．84和0．85±0．47，日本标准确诊PCOS患者与非PCOS患者的LH／FSH分别为1．87±0．76和0．78±0．39，LH／FSH对鹿特丹标准和日本标准诊断为PCOS进行判别时，ROC曲线下面积分别为0．786和0．942。结论LH／FSH≥1对PCO者确诊PCOS有重要的参考价值，且日本标准更适合我国PCOS的诊断。

Objective To investigate the value of ratio of luteinizing hormone （LH） to folliclestimulating hormone （FSH） in diagnosis of polycystic ovarian syndrome （PCOS） among women with ploycystic ovary （ PCO ） and to compare the difference of the diagnostic criteria between the Rotterdam Consensus and the Committee for Reproductive and Endocrine in Japan Society of Obstetrics and Gynecology. Methods By means of transvaginal Doppler ultrasound, 195 women with PCO were diagnosed in Nanfang Hospital of Reproductive Medicine Center and compare difference of multiple clinical indexes according to Rotterdam consensus and Japan consensus respectively. In the mean time, the ratio of LH/FSH, the level of LH, testosterone （T） and recevier operating characteristic （ROC） curve were explored to on the value of diagnosis of PCOS. Results By Rotterdam consensus, 144 women were diagnosed with PCOS and 51 women were non-PCOS, while 111 were identified as PCOS and 84 were non-PCOS according to Japan consensus. LH/FSH in PCOS and non-PCOS were 1.59 ± 0. 84 and 0. 85 ± 0. 47 respectively when based on Rotterdam consensus, and this ratio were 1.87 ± 0. 76 in PCOS and 0. 78 ±0. 39 in non-PCOS based on Japan consensus. When using LH/FSH to diagnosis PCOS by Rotterdam consensus and Japan consensus, areas under ROC curve are 0. 786 and 0. 942, respectively. Conclusions The ratio of LH/FSH ≥ 1 provide the significant value in the diagnosis of PCOS. The criteria of the Committee for Reproductive and Endocrine in Japan Society of Obstetrics and Gynecology is more suitable for Chinese patients.