体检人群多囊卵巢综合征的筛查及影响因素研究

Screening and influencing factors of polycystic ovary syndrome in physical examination population

目的根据育龄妇女体检结果评估其患多囊卵巢综合征(polycystic ovary syndrome,PCOS)的风险,制定育龄女性PCOS筛查流程、评价抗苗勒氏管激素(anti-müllerian hormone,AMH)检测在PCOS诊断中的临床意义.方法选取2018年12月至2019年10月在常德市第一人民医院健康管理中心体检的月经不规律的育龄女性92例,采用Logistic回归分析PCOS患病影响因素,利用受试者工作特征曲线(receiver operating characteristic curve,ROC曲线)分析AMH的临床预测价值.结果AMH辅助诊断PCOS的最佳分界值为5.96 ug/L,灵敏度为79.2%,特异度为77.3%;Logistic回归分析显示体质量指数(body mass index,BMI)和AMH的值越高,彩超提示卵巢多囊样改变(polycystic ovary,PCO)的体检者被诊断为PCOS的风险越高(OR=1.15,95%CI:1.003-1.320;OR=4.83,95%CI:1.777-13.129;OR=496.667,95%CI:24.839-9930.874).结论肥胖、PCO和AMH增高是PCOS的高危因素,建议高风险人群在健康体检基本项目上加做AMH检测.

Objective To evaluate the risk of polycystic ovary syndrome(PCOS) in women of childbearing age according to the physical examination results,and to develop the screening procedure for PCOS in women of childbearing age. To evaluate the diagnostic value of anti-müllerian hormone(AMH) in PCOS.Methods 92 women of childbearing age with irregular menstruation who underwent physical examination inthe Health Management Center of The First People’s Hospital of Changde Cityfrom December 2018 to October2019 were selected. The influencing factors of PCOS disease were analyzed by Logistic regression,and the clinical predictive value of AMH was analyzed by ROC curve.Results The best boundary value of AMH was 5. 96 ug/L,the sensitivity was 79. 2%,and the specificity was 77. 3%. Logistic regression analysis showed that the higher the value of body mass index and AMH,the higher the risk of PCOS diagnosis(OR= 1. 15,95% CI:1. 003-1. 320;OR= 4. 83,95% CI:1. 777-13. 129;OR= 496. 667,95% CI:24. 839-9 930. 874).Conclusion Obesity,increased AMH and PCO are high risk factors for PCOS. It is recommended to add AMH test on the basis of basic physical examination items for high-risk groups.