多囊卵巢综合征患者血清抗米勒管激素和窦卵泡计数水平与卵巢储备功能下降的相关性

The relationship between serum anti-Müllerian hormone and antral follicle count levels in patients with polycystic ovary syndrome and decreased ovarian reserve

目的 探究多囊卵巢综合征(PCOS)患者血清抗米勒管激素(AMH)和窦卵泡计数(AFC)水平及其与卵巢储备功能下降(DOR)发生风险的相关性。方法 选择2021年8月至2022年8月于四川绵阳四○四医院就诊的173例PCOS患者,根据血清卵泡刺激素(FSH)或雌二醇(E_(2))水平,将PCOS患者分为DOR组(45例)和非DOR组(128例),比较两组患者的一般资料及生化指标、AMH和AFC水平及卵巢储备功能相关指标。采用Pearson检验分析PCOS合并DOR患者中AMH、AFC与卵巢储备功能指标的相关性,构建PCOS患者发生DOR的列线图预测模型,并评估其预测效能及准确度和有效性。结果 DOR组患者的AMH、AFC水平明显低于非DOR组,年龄、黄体生成素(LH)、FSH、FSH/LH、E_(2)、睾酮(T)明显高于非DOR组(t=7.417、10.598、2.681、24.222、7.801、11.334和156.602,P<0.05),AMH、AFC分别与FSH、LH、FSH/LH、T呈显著负相关,与E_(2)呈显著正相关(r=-0.574、-0.566、-0.547、-0.528和0.496;t=-0.631、-0.584、-0.603、-0.560和0.545,P<0.05),列线图模型的受试者工作特征(ROC)曲线下面积为0.802(0.764~0.840),灵敏度和特异度分别为85.42%、74.05%。结论 PCOS患者血清AMH和AFC水平与卵巢储备功能相关指标具有明显相关性,与DOR的发生密切相关,对预测PCOS患者发生DOR具有较高价值。

Objective To explore the relationship between serum anti-Müllerian hormone(AMH)and antral follicle count(AFC)levels in patients with polycystic ovary syndrome(PCOS)and the risk of decreased ovarian reserve(DOR).Methods 173 PCOS patients who were treated in Mianyang 404 Hospital from August 2021 to August 2022 were selected.According to serum follicle-stimulating hormone(FSH)or estradiol(E_(2))levels,PCOS patients were divided into DOR group(45 cases)and non-DOR group(128 cases).The general data and biochemical indexes,AMH and AFC levels and ovarian reserve function indexes were compared between the two groups.Using Pearson's test to analyze the correlation between AMH,AFC and ovarian reserve indicators in PCOS patients with DOR.We constructed a nomogram model for the occurrence of DOR in PCOS patients and evaluated its predictive efficacy,accuracy and effectiveness.Results The levels of AMH and AFC in the DOR group were significantly lower than those in the non-DOR group,and the age,luteinizing hormone(LH),FSH,FSH/LH,E_(2) and testosterone(T)in the DOR group were significantly higher than those in the non-DOR group(t=7.417,10.598,2.681,24.222,7.801,11.334 and 156.602,respectively,P<0.05).AMH,AFC were significantly negatively correlated with FSH,LH,FSH/LH and T and significantly positively correlated with E_(2)(r=-0.574,-0.566,-0.547,-0.528,0.496,t=-0.631,-0.584,-0.603,-0.560,0.545,P<0.05 for all).The area under the receiver operating characteristic(ROC)curve of the nomogram model was 0.802(0.764-0.840),and the sensitivity and specificity were 85.42%and 74.05%,respectively.Conclusion Serum levels of AMH and AFC in PCOS patients are significantly correlated with related indicators of ovarian reserve,and are closely associated with the occurrence of DOR,which hold substantial value in predicting the onset of DOR in PCOS patients.