高雄激素和非高雄激素型多囊卵巢综合征患者血清抗苗勒管激素分泌特点及诊断效能比较

被引：59

作者：

李轶

李瑞岐

欧颂邦

张宁峰

陈向红

张清学

杨冬梓

机构：

[1] 中山大学孙逸仙纪念医院生殖医学中心

来源：

实用妇产科杂志 | 2014年 / 30卷 / 02期

关键词：

多囊卵巢综合征; 抗苗勒管激素; 高雄激素血症; 卵泡发育;

D O I：

暂无

中图分类号：

R711.75 [卵巢疾病];

学科分类号：

100211 [妇产科学];

摘要：

目的:比较抗苗勒管激素(AMH)在高雄激素和非高雄激素型多囊卵巢综合征(PCOS)患者的分泌特点和诊断效能,对发病机制进行探讨。方法:纳入具有排卵障碍的PCOS患者131例(高雄组62例,非高雄组69例),另外纳入61例输卵管或男方因素不孕的患者为对照组。采用酶联免疫吸附法和化学发光法检测并比较3组患者血清中AMH、性激素、糖脂代谢等生化指标,采用ROC曲线评估AMH对PCOS患者的诊断效能;采用Pearman's相关法分析高雄和非高雄型PCOS患者血清AMH水平与其他各参数间的关系。结果:①PCOS患者血清AMH水平显著高于对照组(P<0.05),高雄组又显著高于非高雄组(P<0.05)。②AMH诊断高雄组PCOS患者的AUC为0.82,敏感性为82%,特异性为64%。AMH诊断非高雄组PCOS患者的AUC为0.66,敏感性为64%,特异性为62%。③高雄组PCOS患者AMH与FSH呈负相关(r=-0.42,P=0.05),与LH呈正相关(r=0.46,P<0.05)。非高雄组PCOS患者AMH与HDL呈负相关(r=-0.28,P<0.05),与BMI、空腹血糖和LDL呈正相关(r=0.26;r=0.27;r=0.29,P<0.05)。结论:AMH适合于诊断某种特定亚型如高雄激素型PCOS,对非高雄激素型PCOS的诊断准确性较低,由此也反映出两种亚型患者发病机制可能存在差异。

引用

页码：111 / 115

页数：5

共 10 条

[1]

Exercise Decreases Anti-Müllerian Hormone in Anovulatory Overweight Women with Polycystic Ovary Syndrome – A Pilot Study.[J].L. Moran;C. Harrison;S. Hutchison;N. Stepto;B. Strauss;H. Teede.Horm Metab Res.2011, 13

[2]

Follicle-stimulating hormone suppressed excessive production of antimullerian hormone caused by abnormally enhanced promoter activity in polycystic ovary syndrome granulosa cells [J].

Li, Yi ;

Wei, Li-Na ;

Liang, Xiao-Yan .

FERTILITY AND STERILITY, 2011, 95 (07) :2354-U274

[3]

Is the plasma anti-Müllerian hormone (AMH) level associated with body weight and metabolic; and hormonal disturbances in women with and without polycystic ovary syndrome?.[J]..European Journal of Obstetrics and Gynecology.2011, 2

[4]

Reconciling the Definitions of Polycystic Ovary Syndrome: The Ovarian Follicle Number and Serum Anti-Müllerian Hormone Concentrations Aggregate with the Markers of Hyperandrogenism.[J]..The Journal of Clinical Endocrinology & Metabolism.2010, 9

[5]

Serum antimullerian hormone (AMH) levels are elevated in adolescent girls with polycystic ovaries and the polycystic ovarian syndrome (PCOS) [J].

Hart, Roger ;

Doherty, Dorota A. ;

Norman, Robert J. ;

Franks, Stephen ;

Dickinson, Jan E. ;

Hickey, Martha ;

Sloboda, Deborah M. .

FERTILITY AND STERILITY, 2010, 94 (03) :1118-1121

[6]

The Androgen Excess and PCOS Society criteria for the polycystic ovary syndrome: the complete task force report [J].

Azziz, Ricardo ;

Carmina, Enrico ;

Dewailly, Didier ;

Diamanti-Kandarakis, Evanthia ;

Escobar-Morreale, Hector F. ;

Futterweit, Walter ;

Janssen, Onno E. ;

Legro, Richard S. ;

Norman, Robert J. ;

Taylor, Ann E. ;

Witchel, Selina F. .

FERTILITY AND STERILITY, 2009, 91 (02) :456-488

[7]

Anti-Müllerian hormone and ovarian dysfunction.[J].Frank J. Broekmans;Jenny A. Visser;Joop S.E. Laven;Simone L. Broer;Axel P.N. Themmen;Bart C. Fauser.Trends in Endocrinology & Metabolism.2008, 9

[8]

The Use of Anti-Müllerian Hormone in Predicting Menstrual Response after Weight Loss in Overweight Women with Polycystic Ovary Syndrome.[J].Lisa J. Moran;Manny Noakes;Peter M. Clifton;Robert J. Norman.The Journal of Clinical Endocrinology & Metabolism.2007, 10

[9]

Granulosa Cell Production of Anti-Müllerian Hormone Is Increased in Polycystic Ovaries.[J].Laura Pellatt;Laurine Hanna;Mark Brincat;Ray Galea;Henrietta Brain;Saffron Whitehead;Helen Mason.The Journal of Clinical Endocrinology & Metabolism.2007, 1

[10]

Serum Anti-Müllerian Hormone as a Surrogate for Antral Follicle Count for Definition of the Polycystic Ovary Syndrome.[J].P Pigny;S Jonard;Y Robert;D Dewailly.The Journal of Clinical Endocrinology & Metabolism.2006, 3

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