抗苗勒管激素——诊断多囊卵巢综合征的潜在新指标

Anti-Mullerian Hormone:A New Potential Index for Diagnosis of Polycystic Ovary Syndrome

多囊卵巢综合征(PCOS)是育龄期女性最常见的内分泌紊乱疾病之一。近年研究表明,抗苗勒管激素(AMH)与PCOS发生发展的病理生理学过程相关:AMH不仅反映小窦状卵泡数或单纯雄激素水平的升高,更可能反映了包括排卵障碍、代谢异常、遗传特征在内的众多因素的动态交互;在临床实践中,AMH既可以作为窦状卵泡数的替代指标用于PCOS的诊断,也可用于卵巢多囊样改变(PCOM)与PCOS的鉴别、PCOS严重程度的评估乃至PCOS治疗预后的推测、指导治疗方案的选择。有研究表明,AMH大于5 ng/m L或35 pmol/L时,用于诊断PCOS可获得较好的诊断效能。尽管尚未达成专家共识,类似临床研究也未排除各项混杂因素,但是AMH有可能成为一项潜在的PCOS辅助诊断的新指标。

Polycystic ovary syndrome（PCOS） is one of the most common endocrine disorders in women of reproductive age. It was showed that the level of AMH（Anti-Mullerian Hormone） is closely related to the pathophysiology process of PCOS. AMH may reflect the number of antral follicles, but also the dynamic interaction among various factors such as ovulation disorders, metabolic abnormalities, genetic characteristics etc. In clinical practice, AMH could be used to replace polycystic ovary morphology as one of the indicators of PCOS diagnosis criteria. Additionally, it also plays a role in the differential diagnosis between PCOM and PCOS, evaluation of the severity, prediction of the prognosis and the selection of treatment protocol of PCOS. Based on the present research, AMH could reach the preferable specificity and sensitivity with the level over 5 ng/m L or 35 pmol/L when used in the diagnosis of PCOS. AMH could be used as a potential indication in the diagnosis of PCOS although there was not the consensus, and the confounding factors were not fully excluded in those published clinical trials.