抗苗勒管激素在优生优育检测应用中的临床研究

The application value of anti-mullerian hormone in detection of good prenatal and postnatal care

目的通过将抗苗勒管激素(AMH)与性激素六项进行比较,进一步验证抗苗勒管激素在优生优育检查中的临床应用优越性。方法选取2015年1月至2017年1月就诊的246例因卵巢功能导致的育龄期不孕症女性为研究组,结合研究组患者的年龄,将研究组患者分为低龄组和高龄组,并选取140例孕龄期健康者作为对照组,分别观察研究组和对照组及低龄组和高龄组患者血清AMH、促黄体生成素(LH)、促卵泡成熟激素(FSH)、垂体泌乳素(PRL)、雌二醇(E2)、睾酮(T)、孕酮(P)水平,AMH在3个月内的变化情况及不同年龄患者AMH水平以判断血清AMH在优生优育检测中的临床应用价值及相关影响因素。结果研究组患者AMH及E2水平明显低于对照组(P <0. 05),FSH、LH和PRL水平明显高于对照组(P <0. 05),P和T未见明显变化(P> 0. 05),且研究组患者血清AMH在3个月内波动幅度均明显大于对照组,差异有统计学意义(P <0. 05);高龄组患者AMH及E2水平低于低龄患者(P <0. 05),FSH、LH和PRL水平高于低龄患者,差异有统计学意义(P <0. 05);且上述比较中患者AMH数值变化较其他指标敏感性强(P <0. 01),其中高龄患者波动幅度大于低龄患者,差异有统计学意义(P <0. 05)。结论血清AMH、LH、FSH、PRL和E2可作为孕龄期女性卵巢储备功能下降和不孕症诊断的指标性依据,且血清AMH可作为早期判断及诊断卵巢储备功能下降和不孕症的可靠依据。

Objective To further verify the advantages of the clinical application of anti-mullerian hormone in detection of good prenatal and postnatal care by comparing it with the six-items sex hormone indexes.Methods A total of 246 child-bearing age women with infertility caused by hypofunction of ovary who were treated in our hospital from January 2015 to January 2016 were enrolled as research group,according to the subject’s age,they were divided into low age group and high age group,moreover,the other 140 healthy child-bearing age women were enrolled as control group.The changes of serum levels of anti-mullerian hormone(AMH),luteinizing hormone(LH),follicle stimulating hormone(FSH),pituitary prolactin(PRL),estradiol(E2),testosterone(T),progesterone(P)within 3 months were observed to evaluate the application value of AMH in detection of good prenatal and postnatal care and related influencing factors.Results The levels of AMH and E2 in research group were significantly lower than those in control group(P<0.05),and the levels of FSH,LH and PRL were significantly higher than those in control group(P<0.05),however,there were no significant differences in the levels of P and T between the two groups(P >0.05).Moreover the fluctuation extent within 3 months in research group was more significant than that in control group(P<0.05).Moreover the levels of AMH and E2 in high age group were significantly lower than those in low age group(P<0.05),however,the levels of FSH,LH and PRL in high age group were significantly higher than those in low age group(P<0.05),moreover,the sensitivity of AMH was the highest in these indexes,in which,the fluctuation extent in high age group was more significant than that in low age group(P<0.05).Conclusion The serum levels of AMH,LH,FSH,PRL and E2 can be regarded as the indexes to diagnose hypofunction of ovary and infertility in child-bearing age women,moreover,the serum levels of AMH can be regarded as reliable basis to diagnose early the hypofunction of ovary and infertility in child-bearing age women.