血清抗缪勒管激素在多囊卵巢综合征诊断中的应用价值

Application value of serum anti-mullerin hormone in the diagnosis of polycystic ovary syndrome

目的 探究血清抗缪勒管激素(AMH)对多囊卵巢综合征(PCOS)的诊断价值。方法 采用电化学发光法对128例诊断为多囊卵巢综合征的患者(PCOS组)、194例同期年龄相匹配的正常女性的血清样本进行AMH水平检测。采用统计软件对数据进行分析。结果 PCOS组的AMH水平明显高于对照组(P<0.01),PCOS组和对照组AMH水平中位数(四分位数)分别为7.24(4.99~11.18) ng/ml和3.91(2.55~6.13) ng/ml;对照组AMH水平与年龄呈负相关(R2=0.306,P<0.01);PCOS组AMH水平与年龄无相关性(R2=0.029,P> 0.05);AMH诊断ROC曲线的ROCAUC为0.819,敏感度为72.7%,特异度为77.3%,具有较好的诊断价值;按年龄分层后,AMH诊断PCOS的临界值逐渐减小(18岁~24岁:8.41 ng/ml、25岁~29岁:5.00 ng/ml、30岁~37岁:4.76 ng/ml)。结论 PCOS组的AMH水平高于对照组;对照组的AMH水平随着年龄的增高而降低,PCOS组的AMH水平与年龄没有相关性;AMH诊断PCOS具有较高的敏感度和特异度,是较好的指标,且AMH诊断PCOS的临界值随着年龄增大而减小,推荐建立年龄分层的诊断标准。

Objective To explore the diagnostic value of serum anti-Muller hormone(AMH) in polycystic ovary syndrome(PCOS).Methods A total of 128 patients in the PCOS group and 194 patients in the age-matched control group were collected.Serum AMH level of the two groups was detected by electrochemiluminescence.Statistical software was used to analyze the data.Results The level of AMH in PCOS group was significantly higher than that in control group(P 0.05);The ROC curve of AMH diagnosis was0.819,with the sensitivity of 72.7%,and the specificity of 77.3%,and it had good diagnostic value.After classification by age,the threshold value of PCOS diagnosed by AMH gradually decreased(18-24 years old:8.41 ng/ml,25-29 years old:5.00 ng/ml,30-37 years old:4.76 ng/ml).Conclusion The level of AMH in PCOS group was higher than that in control group.The level of AMH in the control group decreased with the increase of age,while the level of AMH in the PCOS group was not correlated with age.AMH has high sensitivity and specificity in the diagnosis of PCOS,which is a good indicator,and the critical value of AMH in the diagnosis of PCOS decreases with the increase of age.Therefore,it is suggested to establish age-classified diagnostic criteria.