实验室检查指标对于多囊卵巢综合征患者排卵障碍的筛查效能

Efficacy of Laboratory Test Indicators for Screening Ovulation Disorders in Patients with Polycystic Ovary Syndrome

目的探讨实验室化验指标对多囊卵巢综合征(PCOS)患者排卵障碍的筛查价值。方法选取2019年8月-2021年12月初次确诊的多囊卵巢综合征患者140例,根据有无排卵障碍将其分为有排卵障碍组和无排卵障碍组,收集其临床信息及各项实验室检查指标[抑制素B(INHB)、抗缪勒氏激素、同型半胱氨酸(Hcy)、性激素6项、胰岛素和血糖],分析其相关性。后将上述患者按100∶40分为发现组和验证组,进行受试者工作特性曲线(ROC)分析,明确实验室检查指标对于排卵障碍的筛查效能。结果有排卵障碍组和无排卵障碍组的INHB与胰岛素抵抗稳态模型(HOMA-IR)比较,差异有统计学意义(P<0.05);ROC曲线显示,发现组中INHB诊断排卵障碍的灵敏度和特异度为66.07%、52.27%,AUC面积0.587,HOMA-IR诊断排卵障碍的灵敏度和特异度为53.57%、63.18%,AUC为0.618,两者合并后的特异度为72.73%,AUC为0.650,同型半胱氨酸(Hcy)筛查PCOS患者排卵障碍的特异度为97.73%;根据得出的临界值(Cut-off)进行验证,验证组结果显示,INHB诊断排卵障碍的灵敏度和特异度为65.00%、50.00%,HOMA-IR诊断排卵障碍的灵敏度和特异度为55.00%、65.00%,Hcy的特异度为95.00%。结论INHB及HOMA-IR可作为筛查PCOS患者排卵障碍的实验室指标,结合Hcy可提高其准确率,有助于监控重点患者、早期干预,及保护患者的生育力。

Objective To investigate the value of laboratory tests for screening ovulation disorders in patients with polycystic ovary syndrome(PCOS).Methods A total of 140 patients with polycystic ovary syndrome who were initially diagnosed from August 2019 to December 2021 were selected.According to the presence or absence of ovulation disorder,they were divided into ovulation disorder group and non-ovulation disorder group.Their clinical information and various laboratory examination indicators[inhibin B(INHB),anti-Mullerian hormone,homocysteine(Hcy),six sex hormones,insulin and blood glucose]were collected,and their correlation was analyzed.The above patients were divided into the discovery group and the verification group according to 100:40,and the receiver operating characteristic curve(ROC)analysis was performed to determine the screening efficacy of laboratory examination indicators for ovulation disorders.Results There was a statistically significant difference between INHB and insulin resistance homeostasis model(HOMA-IR)in the ovulatory disorder group and the non-ovulatory disorder group(P<0.05).ROC curve showed that the sensitivity and specificity of INHB in the diagnosis of ovulation disorders were 66.07%and 52.27%,and the AUC area was 0.587;the sensitivity and specificity of HOMA-IR in the diagnosis of ovulation disorders were 53.57%and 63.18%,and the AUC was 0.618;the combined specificity was72.73%,and the AUC was 0.650;the specificity of homocysteine(Hcy)in screening ovulation disorders in PCOS patients was 97.73%.According to the Cut-off for verification,the results of the validation group showed that the sensitivity and specificity of INHB in the diagnosis of ovulation disorder were 65.00%and 50.00%,the sensitivity and specificity of HOMA-IR in the diagnosis of ovulation disorder were 55.00%and 65.00%,and the specificity of Hcy was 95.00%.Conclusion INHB and HOMA-IR can be used as laboratory indicators for screening ovulation disorders in PCOS patients.Hcy can improve its accuracy and help to monitor the key patients to early intervention,and protect the fertility of patients.