抗苗勒氏管激素与多囊卵巢综合症治疗效果的相关性

Correlation of anti-mullerian hormone and the effect of polycystic ovary syndrome treatment

目的:研究多囊卵巢综合症治疗效果和抗苗勒氏管激素(Anti-Mullerian hormone,AMH)的相关性。方法:收集我院门诊2015年11月至2016年2月多囊卵巢综合征不孕症患者,排除其他因素后纳入140例。根据患者空腹血糖、空腹胰岛素和雄激素值分组:对照组:空腹血糖、空腹胰岛素和雄激素正常;糖代谢异常组:空腹血糖或/和空腹胰岛素升高,雄激素正常;高雄激素组:雄激素升高,空腹血糖或/和空腹胰岛素正常;糖代谢异常合并高雄激素组:空腹血糖或/和空腹胰岛素升高和雄激素升高的。给予达英-35或/和二甲双胍治疗后比较各组治疗前后和组间的抗苗勒氏管激素(Anti-Mullerian hormone,AMH)、空腹血糖、空腹胰岛素、胰岛素抵抗指数和雄激素变化。结果:糖代谢异常组,高雄激素组和糖代谢异常合并高雄激素组的AMH值,明显高于对照组(P<0.05)。其中糖代谢异常合并高雄激素组的AMH值明显高于糖代谢异常组及高雄激素组(P<0.05)。药物治疗后各组的AMH值比未治疗前均有明显下降(P<0.05)。结论:AMH、糖代谢和雄激素三者可能具有互相影响、互相作用的关系。血清AMH水平为诊断和研究PCOS提供了一个重要的突破点。

Objective. To study the correlation of anti-mullerian hormone and the effect of polycystic ovary syndrome treatment. Methods： Infertility outpatients with polycystic ovary syndrome service in November 2015 to February 2016 were collected, and 140 cases were included. According to patients＇ fasting glucose, fasting insulin and testosterone, all cases are divided into four groups. Control group： normal fasting blood glucose, fasting insulin and testosterone; sugar metabolic abnormalities group： higher fasting glucose and/or fasting insulin, testosterone is normal l high testosterone group; higher testosterone fasting glucose and/or fasting in- sulinare normal; sugar metabolic abnormalities merged high testosterone group., higher fasting glucose and/or fasting insulin and tes- tosterone. AMH, fasting glucose, fasting insulin, insulin resistance index and testosterone before and after treatment by tale-35 and/ or metformin were compared between groups. Results： The values of AMH in all the other groups were significantly higher than the values of AMH in control group （P〈0.05）. The values of AMH in the sugar metabolic abnormalities merged testosterone group was obviously higher than that of sugar metabolic abnormalities and high testosterone group （P〈0.05）. After drug treatment, AMH val- ues were significantly lower than before in all groups （P〈0.05）. Conclusion： AMH, sugar metabolism and testosterone may have an impact on each other. Serum AMH level provides an important breakthrough for PCOS diagnostic and research.