抗苗勒管激素与不同表型多囊卵巢综合征发病特征的相关性分析

Analysis of the characteristics and correlation of anti-Müllerian hormone in different phenotypic polycystic ovary syndrome

目的探讨不同表型多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者血清抗苗勒管激素(AMH)及性激素指标水平,并评估AMH与这些指标的相关性。方法应用UNION免疫分析仪和Uni Cel Dx I800免疫分析系统检测702例PCOS患者和118例健康女性(对照组)AMH和其他性激素水平,并进行超声下窦卵泡计数(AFC)和卵巢体积测量。应用Pearson分析进行双变量相关分析。结果 PCOS患者的卵泡刺激素(FSH)低于对照组,其中无排卵或稀发排卵(OA)+高雄激素血症(HA)+多囊卵巢(PCO)组与对照组间的差异具有统计学意义(P<0.05)。黄体生成素(LH)、L H/F S H、AMH均显著高于对照组。血清睾酮(T)水平在O A+H A组和O A+H A+P C O组显著升高。各组间泌乳素(P R L)、雌二醇(E2)水平无明显差异。A M H与F S H呈负相关,与L H、L H/F S H、T、A F C、左卵巢体积和右卵巢体积呈正相关。结论血清AMH浓度可以反映窦卵泡的数目和血清T的浓度高低,可作为PCOS诊断与监测指标之一,提高PCOS诊断的简便性,在临床上有广泛的应用前景。

bjectiveTo investigate the levels of serum anti-Müllerian hormone （AMH） and sex hormone in patients with different types of polycystic ovary syndrome （PCOS） and to evaluate the correlation between AMH and these indexes.MethodsAMH and other sex hormone levels of 702 patients with PCOS and 118 healthy women （control group） were examined by UNION immunoassay and UniCel DxI800 immunoassay. Ultrasound was used to measure antral follicle count （AFC） and ovarian volume. Bivariate correlation analysis was performed by Pearson correlation analysis.ResultsThe follicle-stimulating hormone（FSH） of PCOS patients was lower than that of the control, and the difference was partial statistically significant between oligo and/or anovulation （OA）＋hyperandrogenism （HA）＋polycystic ovaries （PCO） group and the control. The levels of luteinizing hormone （LH）, LH/FSH, AMH were significantly higher than those in the control. Serum testoterone （T） level was significantly higher in OA＋HA and OA＋HA＋PCO types of PCOS. There was no significant difference between prolactin （PRL） and estradiol （E2） in each group. AMH was negatively correlated with FSH and positively correlated with LH, LH/FSH, T, AFC, left ovarian volume and right ovarian volume.ConclusionThe serum AMH concentration can reflect the number of antral follicles and the concentration of serum T, which can be used as one of the diagnostic and monitoring indicators of PCOS, improve the simplicity of PCOS diagnosis, and has wide application prospect in clinic.