深圳地区健康育龄妇女血清中AMH水平现况及其在PCOS和POF诊疗中的价值

Status of AMH in Serum of Healthy Women in Shenzhen Area and Its Value in PCOS and POF Treatment

目的了解深圳地区健康育龄妇女血清中抗苗勒氏管激素(anti-Mullerian hormone,AMH)水平现况,并探讨其在多囊卵巢综合征(PCOS)和卵巢早衰(POF)诊疗中的价值。方法收集2016年1月～2017年3月来深圳市宝安区人民医院体检的健康育龄妇女860例为对照组,并选择同期就诊的PCOS患者59例和POF患者61例,采用DXI800化学发光分析仪分别检测对照组、PCOS和POF组患者治疗前及治疗3个月后血清中AMH水平,并对检测结果进行统计分析。结果健康育龄妇女血清中AMH水平为4.91±1.56 ng/ml,其中18～25岁组为5.38±1.27 ng/ml,31～35岁组和36～42岁组分别为4.53±1.40 ng/ml和3.95±1.16 ng/ml,明显低于18～25岁组,差异有统计学意义(t=3.082,5.066,均P<0.05),而26～30岁组为5.09±1.45 ng/ml,与18～25岁组之间差异无统计学意义(t=0.892,P>0.05)。治疗前,PCOS患者血清中AMH水平为10.13±3.85 ng/ml,明显高于对照组,差异有统计学意义(t=13.924,P<0.01),而POF组和围POF组患者血清中AMH水平分别为1.04±0.37 ng/ml和2.39±0.87 ng/ml,明显低于对照组,差异有统计学意义(t=10.913,8.042,均P<0.05),且POF组低于围POF组,差异有统计学意义(t=2.875,P<0.05)。治疗后,PCOS患者血清中AMH水平为5.22±1.58 ng/ml,明显低于治疗前,差异有统计学意义(t=11.106,P<0.05),而与对照组之间差异无统计学意义(t=1.036,P>0.05),POF组和围POF组患者血清中AMH分别为4.49±1.32ng/ml和4.54±1.47 ng/ml,明显高于治疗前,差异有统计学意义(t=9.608,7.253,均P<0.05),而与对照组之间差异均无统计学意义(t=1.209,0.918,均P>0.05)。结论治疗前,PCOS患者血清中AMH水平明显升高,POF和围POF患者血清中明显降低,而治疗后PCOS,POF和围POF患者血清中AMH水平均恢复正常。因此,AMH在PCOS和POF疾病诊疗中具有一定的应用价值,值得推广应用。

Objective To investigate the current status of anti-mullerian hormone （AMH） in healthy women in the healthy childbearing age＇in Shenzhen area,and to explore its application value in polycystic ovary syndrome （PCOS） and prature ovarian syndrome （POF） treatment. Methods Collected 860 cases of medical health women of childbearing age in Shenzhen Baoan District People＇s Hospital from January 2016 to March 2017 as control group,and at the same time selected 59 cases of patients with PCOS and 61 cases of patients with POF as observation group. Adopted DXI800 chemiluminescence analyzer to test serum AMH level of control group,patients with PCOS and POF group respectively before and 3 months after treat- ment,and the testing results were analyzed. Results The serum AMH level of Healthy women of childbearing age was 4.91 521.56 ng/ml,18-25 years old group was 5.38＋1.27 ng/ml,31-35 and 36-42 years old group were 4.53＋1.40 ng/ml and 3. 954-1.16 ng/ml,being all lower than that in group 18-25 years old （t=3. 082,5. 066,all P〈0.05）. While 26-30 years old group was 5.09±1.45 ng/ml,and compared with 18-25, there was no statistically significant difference （t= 0. 892, P）〉0. 05）. Before the treatment, the serum AMH level of PCOS was 10. 13 ± 3. 85 ng/ml, significantly higher than the control group,the difference was statistically significant （t~ 13. 924,P〈0.01）,while the serum AMH level of POF group and wait POF patients were 1.04±0.37 ng/ml and 2.39±0.87 ng/ml,significantly lower than the control group （t=10. 913,8. 042,all P〈0.05）, and POF lower than wait POF group （t= 2. 875, P〈0.05）. Alter treatment, the serum AMH level of PCOS was 5.22± 1.58 ng/ml, significantly lower than before treatment （t= 11. 106, P〈0.05）, and there was no statistically significant difference between control group （t= 1. 036,P〈G 05） ,the serum AMH level of POF and wait POF were 4.49：k 1.32 ng/ml and 4. 54±1.47 ng/ml, significantly higher than the before treatment （t= 9. 608,7. 253, all P〈 0.05） ,and compared with the control group there were no statistically significant differences （t= 1. 209,0. 918, all P〈0.05）. Conclusion Before the treatment,the serum AMH levels of PCOS were increased significantly,and the serum AMH levels of POF and wait POF patients were significantly reduced,while the serum AMH levels of PCOS,POF and wait POF patients were all restored to normal levels after treatment. Therefore, AMH has certain application value in the diagnosis and treatment evaluation of women PCOS and POF disease.