卵巢早衰患者血清IL-21、AMH水平变化及其诊断价值

Changes of serum IL-21,and AMH of women with premature ovarian failure and their diagnostic value

目的:探讨血清白细胞介素-21(IL-21)、抗苗勒管激素(AMH)在卵巢早衰(POF)患者中的变化及其临床意义。方法:选取本院妇科确诊的POF患者100例(POF组)、健康体检且月经周期正常妇女100例为对照组,检测两组血清IL-21、AMH、窦卵泡计数(AFC)、卵泡刺激素(FSH)、雌二醇(E2)、黄体生成素(LH);采用受试者工作曲线(ROC)分析血清IL-21、AMH诊断OPF效能。结果:POF组血清IL-21、FSH、LH水平高于对照组,AMH、AFC、E2水平低于对照组(均P<0.05)。POF组血清IL-21与FSH、LH水平呈正相关关系,与AFC、E2水平呈负相关关系;AMH与AFC水平呈正相关关系,与FSH水平呈负相关关系(均P<0.05)。ROC曲线分析,血清IL-21诊断POF灵敏度为87.2%、特异度为74.6%、AUC值为0.844;血清AMH诊断POF的灵敏度为96.4%、特异度为90.4%、AUC值为0.912。结论:血清IL-21、AMH水平对POF病情判断及诊断有一定临床价值。

Objective:To investigate the changes of serum Interleukin-21(IL-21)and anti-mullerian hormone(AMH)of women with premature ovarian failure(POF),and to study their clinical significance.Methods:100 women with POF were selected in study group,and 100 healthy women with normal menstrual cycles were selected in control group.The levels of serum IL-21,AMH,antral follicle count(AFC),follicle stimulating hormone(FSH),estrogen(E2),and luteinizing hormone(LH)of women in the two groups were measured.The receiver operating curve(ROC)was used to analyze the value of serum IL-21 and AMH levels for diagnosing OPF.Results:The levels of serum IL-21,FSH and LH of women in the study group were significant higher than those of women in the control group(P<0.05).The serum AMH,AFC and E2 levels of women in the study group were significant lower than those in the control group(P<0.05).The levels of serum IL-21,FSH and LH of women in the study group were significant higher than those of women in the control group,and the serum levels of AMH,AFC and E2 of women in the study group were significant lower than those of women in the control group(all P<0.05).In the study group,serum IL-21 level of women was positively correlated with their FSH and LH levels,and was negatively correlated with their AFC and E2 levels.In the study group,serum AMH level of women was positively correlated with their AFC level,and was negatively correlated with their FSH level(all P<0.05).According to ROC curve analysis,the sensitivity,the specificity,and AUC of the serum IL-21 level for diagnosing POF were 87.2%,74.6%,and 0.844,respectively.The sensitivity,the specificity and AUC of the serum AMH level for diagnosing POF were 96.4%,90.4%,and 0.912,respectively.Conclusion:The changes of serum IL-21 and AMH of women have certain clinical values for diagnosing POF and judging the disease status of POF.