血清抗苗勒管激素在预测围绝经期女性卵巢功能中的应用

Application of anti-mullerian hormone serum in predicting ovarian functions of perimenopausal women

目的观察血清抗苗勒管激素(AMH)在围绝经期女性中的变化,探讨AMH用于评估卵巢功能的意义。方法选取月经失调患者60例,根据卵巢功能分为围绝经期组和卵巢早衰组(POF组),各30例;选取同期月经周期正常、无内分泌疾病、年龄在35～45岁的健康妇女30例,作为对照组。分别于就诊当月或下月月经周期第2～3天(闭经者日期不限),检测各组血清AMH、卵泡刺激素(FSH)、黄体生成激素(LH)、雌二醇(E2)水平,其中围绝经期组6、12个月之后重复检测上述项目。结果与对照组比较,POF组血清AMH、E2水平下降,FSH、LH水平上升(P均<0.05);与对照组比较,围绝经期组血清AMH下降(P<0.05),FSH水平稍上升,LH、E2在正常水平(P均>0.05);POF组血清AMH水平低于围绝经期组(P<0.05);围绝经期组6个月后重复检测,血清AMH水平较就诊时下降(P<0.05),而FSH、LH、E2水平变化不明显(P均>0.05);12个月后,血清AMH水平进一步下降,FSH、LH水平上升,E2水平下降,P均<0.05。结论血清AMH比FSH、LH、E2更早反映卵巢功能下降,能更早预测围绝经期妇女卵巢功能衰退。

Objective To analyze the application of anti-mullerian hormone （AMH） serum in perimenopausal women so as to discuss the significance of anti-mullerian hormone serum in assessing the ovarian functions. Methods A total of 60 patients with menstrual disorder were selected and they were divided into two observation groups： the perimenopausal group and the premature ovarian failure group （POF group） , 30 in each group. Meanwhile, 30 healthy women aged from 35 to 45 with the normal menstrual cycle （28 to 35d） and no endocrine diseases were selected as the control group. The se- rum ovarian hormone FSH, LH, Ez and AMH of the patients were tested in the visiting month or the 2no to 3rd day of the next month （ any date for amenorrhoea women）. The above items of the patients in the perimenopausal group may be retest- ed after six months or one year. Results Compared with the control group, the levels of AMH and E2 in the POF group decreased （P 〈 O. 05） , whereas the levels of FSH and LH increased （P 〈 0.05） ; compared with the control group, AMH in the perimenopausal group was lower （ P 〈 0.05 ）, FSH was higher, and no obvious changes in LH and E2 （ P 〉 0.05 ）. The level of AMH in the POF group was lower than that in the perimenopausal group （ P 〈 0.05 ）. After 6 months, the a- bove hormones were retested in the perimenopausal group, the level of AMH was lower than the preliminary test （P 〈 O. 05）, whereas no obvious changes in FSH, LH and E2 （P 〉 0.05）. To compare the above hormones retested after 12 months in the perimenopausal group, AMH decreased obviously, FSH and LH increased greatly and E2 decreased （P 〈 0.05）. Conclusion The serum AMH can reflect the decreased ovarian functions earlier than FSH, LH and Ez, thus it can predict the decline of the ovarian functions of perimenopausal women earlier.