血清性激素水平联合AMH水平测定在早发性卵巢功能不全早期筛查中的应用

Application of Serum Sex Hormone Levels Combined with AMH Level Determination in Early Screening of Premature Ovarian Insufficiency

目的:血清性激素水平联合抗米勒管激素(AMH)水平测定在早发性卵巢功能不全(POI)早期筛查中的应用。方法:选取2019年1月-2021年12月南平市人民医院收治的40例POI患者作为疾病组,另选取同期健康体检者35例作为健康组。比较疾病组与健康组血清性激素[促卵泡激素(FSH)、雌二醇(E_(2))、促黄体生成素(LH)]及AMH水平,分析AMH与各项性激素的相关性,并分析上述指标对于早期筛查早发性卵巢功能不全的筛查价值。结果:疾病组FSH、LH水平均高于健康组,E_(2)、AMH水平均低于健康组(P<0.05)。AMH与FSH、LH均呈负相关,与E_(2)呈正相关(P<0.05)。血清性激素诊断POI的敏感度、特异度、AUC分别为82.50%(33/40)、85.71%(30/35)、0.896,各项血清性激素联合诊断POI的敏感度、AUC均高于单项诊断。血清性激素联合AMH诊断POI的敏感度、特异度、AUC分别为97.50%(39/40)、85.71%(30/35)、0.964,血清性激素联合AMH诊断POI的敏感度、AUC均高于单独预测。结论:血清FSH、LH在POI中呈高表达,且血清AMH、E_(2)在POI患者中呈低表达,且AMH与各项性激素具有一定的相关性,AMH与性激素对POI早期筛查均具有一定价值,且联合诊断的效能更高。

Objective:To evaluate the application of serum sex hormone levels combined with anti-Müllerian hormone(AMH)levels in the early screening of premature ovarian insufficiency(POI).Method:A total of 40 patients with POI who were admitted to People’s Hospital of Nanping City from January 2019 to December 2021 were selected as the disease group,and 35 healthy subjects during the same period were selected as the healthy group.The levels of serum sex hormones[follicle-stimulating hormone(FSH),estradiol(E_(2)),luteinizing hormone(LH)]and AMH in the disease group and healthy group were compared,and the correlation between AMH and various sex hormones were analyzed,the value of the above indexes for early screening of POI was analyzed.Result:The levels of FSH and LH in the disease group were higher than those in the healthy group,and the levels of E_(2) and AMH in the disease group were lower than those in the healthy group(P<0.05).AMH was negatively correlated with FSH and LH,and positively correlated with E_(2)(P<0.05).The sensitivity,specificity and AUC of serum sex hormones for the diagnosis of POI were 82.50%(33/40),85.71%(30/35)and 0.896,respectively.The combined sensitivity and AUC of serum sex hormones were higher than those of single diagnosis.The sensitivity,specificity and AUC of serum sex hormone combined with AMH in the diagnosis of POI were 97.50%(39/40),85.71%(30/35)and 0.964,respectively.The sensitivity and AUC of serum sex hormone combined with AMH in the diagnosis of POI were higher than those of single prediction.Conclusion:Serum FSH and LH are highly expressed in POI,and serum AMH and E_(2) are lowly expressed in POI patients,and AMH has a certain correlation with various sex hormones,both AMH and sex hormones have certain value in the early screening of POI,and the combined diagnosis is more efficient.