多囊卵巢综合征患者雄激素水平与抗苗勒管激素、抑制素B水平的关系研究

Relationship among levels of androgen,anti-Müllerian hormone and inhibin B in patients with polycystic ovary syndrome

目的探讨不同雄激素水平的多囊卵巢综合征(PCOS)患者血清抗苗勒管激素(AMH)、抑制素B(INHB)的变化及其临床意义。方法选取青海省妇幼保健院确诊的PCOS患者130例作为PCOS组、65例月经周期女性作为对照组,检测两组的血清AMH、INHB水平、2~9 mm卵泡数、卵巢体积、雄激素(T)水平并进行对比;将PCOS组根据血清雄激素水平分为高雄激素血症组(HA组,88例,T≥1.97 nmol/L)、非高雄激素血症组(NHA组,42例,T<1.97 nmol/L)对比上述指标。结果PCOS组患者的血清AMH、2~9 mm卵泡数、卵巢体积、T水平均高于对照组(AMH:9.32±2.80比5.20±1.41,P<0.05);PCOS组和对照组的INHB水平差异无统计学意义(P>0.05);HA组患者的血清INHB、T水平均高于NHA组(P<0.05);HA组的AMH水平与NHA组差异无统计学意义(P>0.05);HA组的2~9 mm卵泡数、卵巢体积均低于NHA组(P<0.05);PCOS组的血清INHB与T水平呈正相关(P<0.05),与卵巢体积呈负相关(P<0.05);PCOS组患者血清AMH与卵巢体积、2~9 mm卵泡数、血清T水平均呈正相关(P<0.05)。结论AMH、INHB水平在可能与PCOS患者卵巢体积、卵泡发育及雄激素水平变化有关。

Objective To investigate the alterations and clinical significance of serum anti-Müllerian hormone(AMH)and inhibin B(INHB)in polycystic ovary syndrome(PCOS)with different androgen levels.Methods Included in this study were 130 PCOS patients diagnosed in Qinghai Maternal and Children’s Hospital(PCOS group)and 65 women with normal menstrual cycle(control group).The two groups were examined and compared for serum AMH and INHB levels,2-9 mm follicles count,ovarian volume,and androgen(T)level.These indicators were further compared among PCOS patients stratified into hyperandrogenemia group(HA group,n=88 cases,T≥1.97 nmol/L)and non-hyperandrogenemia group(NHA group,n=42,T<1.97 nmol/L)according to serum androgen levels.Results The serum AMH,2-9 mm follicles count,ovarian volume and T level in the PCOS group were higher than those in control group(AMH:9.32±2.80 vs 5.20±1.41,P<0.05).There was no significant difference in INHB level between PCOS and control groups(P>0.05).The serum levels of INHB and T in the HA group were higher than those in the NHA group(P<0.05).There was no significant difference in AMH level between the HA and NHA groups(P>0.05).The 2-9 mm follicles count and ovarian volume were lower in the HA than those in the NHA group(P<0.05).In the PCOS group,the serum INHB level was correlated positively with T level(P<0.05),and negatively with ovarian volume(P<0.05);the serum AMH was positively correlated with ovarian volume,2-9 mm follicles count,and serum T level(P<0.05).Conclusion The levels of AMH and INHB may be correlated with alteratioins in ovarian volume,follicular development and androgen levels in PCOS patients.