[1]董 莉,张保平,冯新平,等.血清雄性激素、AMH检测 在女性不孕诊断中的应用价值[J].现代检验医学杂志,2016,31(03):77-80.[doi:10.3969/j.issn.1671-7414.2016.03.021]
　DONG Li,ZHANG Bao-ping,FENG Xin-ping,et al.Value of Testing Serum Testosterone and AMH in the Diagnosis of Female Infertility[J].Journal of Modern Laboratory Medicine,2016,31(03):77-80.[doi:10.3969/j.issn.1671-7414.2016.03.021]
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血清雄性激素、AMH检测 在女性不孕诊断中的应用价值()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第31卷
期数:
2016年03期
页码:
77-80
栏目:
论著
出版日期:
2016-06-15

文章信息/Info

Title:
Value of Testing Serum Testosterone and AMH in the Diagnosis of Female Infertility
文章编号:
1671-7414(2016)03-077-04
作者:
董 莉; 张保平; 冯新平; 萨仁娜; 王悦喜
内蒙古医科大学附属医院检验科,呼和浩特 010050
Author(s):
DONG Li; ZHANG Bao-ping; FENG Xin-ping; SA Ren-na; WANG Yue-xi
Department of Clinical Laboratory,Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010050,China
关键词:
雄激素;  抗苗勒氏管激素;  女性不孕;  相关性
分类号:
R711.6; R392.6
DOI:
10.3969/j.issn.1671-7414.2016.03.021
文献标志码:
A
摘要:
目的 探讨雄激素、抗苗勒氏管激素(AMH)对女性不孕诊断中的应用价值。方法 用化学发光法检测258例女性不孕患者雄激素睾酮(To)、雄烯二酮(AND)、硫酸去氢表雄酮(17HS)、性激素结合球蛋白(SHG)和抗苗勒氏管激素(anti-Müllerian hormone,AMH); 女性不孕患者按照不孕原因分观察组(内分泌性不孕158例)和对照组(输卵管因素不孕100例),两组数据采用t检验进行统计学分析; 采用Pearman's 相关法分析女性不孕患者血清AMH水平与AND,SHG间的关系; 采用ROC曲线评估AND和AMH对女性不孕的诊断效能。结果 ①观察组与对照组的各项指标To,AND,AMH,SHG分别为(1.25±0.41 vs 0.25±0.15)nmol/L,(4.9±0.62 vs 1.80±0.51)nmol/L,(13.6±3.5 vs 6.4±1.81)ng/ml和(64.2±32.1 vs 89.3±30.2)nmol/L,与对照组比较,观察组To,AND和AMH显著高于对照组(t=13.02,11.36,9.35,P值均<0.01),SHG则明显低于对照组(t=7.35,P<0.01),差异具有统计学意义; ②以生物学参考区间(AMH:7.63～10.1 ng/ml,AND:0.3～3.3 ng/ml,17HS:18～144 μg/dl,SHG:80～560 nmol/L)为标准,观察组中17HS增高占17.7%,AND增高占72.2%,AMH增高占87.9%,SHG降低51.2%; ③AMH水平与AND存在正相关(r=0.579,P<0.05),与SHG存在负相关(r=0.763,P<0.05); ④AMH,AND和SHG诊断不孕的ROC 曲线下面积(AUC)分别为0.921,0.863,0.736; 最佳cutoff值分别为11.26 ng/ml,4.62 nmol/L和32.62 ng/ml,灵敏度分别为89.7%,72.9%和59.6%,特异度分别为86.2%,98.5%和75.6%,准确度分别为87.1%,81.6%和51.2%。联合检查AND,AMH和SHG诊断不孕的灵敏度、特异度分别为96.3%和90.2%。结论 用ROC曲线分析的结果表明AMH,AND和SHG对内分泌性不孕具有诊断价值; 联合检测AMH和AND,SHG对不孕症的早期诊断和治疗更有意义。
Abstract:
Objective To study the application of androgens,AMH for female infertility diagnosis value.Methods Used chemiluminescence to detect androgen testosterone(To),androstenedione(AND),17(HS)To hydrogen sulfate therapy(17HS),sex hormone binding globulin(SHG)and resistance To seedling le's hormone(anti-Mullerian hormone,AMH)of 258cases of patients with female infertility.According to the reason of infertility,female infertility patients were divided into observation group(158 cases of endocrine infertility)and control group(100 cases of tubal factor infertility)and two groups of data had statistical analysis with t test.Used Pearman's correlation method to analyse the relationship between serum AMH level and AND,SHG in patients wirh female infertility.and used ROC curve to evaluate efficiency of AND and AMH to the diagnosis of female infertility.Results①The indicators To observation group AND control group,AND,AMH and SHG were(1.25±0.41 vs 0.25±0.15)nmol/L,(4.9±0.62 vs 1.80±0.51)nmol/L,(13.6±3.5 vs 6.4±1.81)ng/ml and(64.2±32.1 vs 89.3±30.2)nmol/L,respectively.Compared with the control group,observation group To,AND and AMH were significantly higher than the control group(t=13.02,11.36,9.35,P values<0.01),but SHG was significantly lowwer than thecontrol group(t=7.35,P<0.01).②Between the biology to produce ets(AMH:7.63～10.1 ng/ml,AND:0.3～3.3 ng/ml,17 HS:18～144 μg/dl,SHG:80～560 nmol/L)as the standard,in the observation group:17 HS increased 17.7%,AND increased 72.2%,AMH increased 87.9% and SHG 51.2% reduction.③AMH level and the AND existed positive correlation(r=0.579,P<0.05),negatively correlated with SHG(r=0.763,P<0.05).④AMH,AND and SHG diagnosis of infertility area under the ROC curve(AUC),were 0.921,0.863 and 0.736 respectively,best cutoff value were 11.26 ng/ml,4.62 nmol/L and 32.62 ng/ml respectively,and sensitivity of 89.7%,72.9% and 59.6%.Specific degrees were 86.2%,86.2% and 75.6% respectively,and accuracy of 87.1%,87.1% and 81.6%.Jointed inspection of AND,AMH and SHG in the diagnosis of infertility,the sensitivity of the specific degree were 96.3% and 90.2% respectively.Conclusion It showed that AMH,AND and SHG have diagnostic value of internal secretory infertility with ROC curve analysis.Detection of combined AMH,AND and SHG is more meaningful to the early diagnosis and treatment of infertility.

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备注/Memo

备注/Memo:
作者简介:董 莉(1964-),女,大学本科,主任检验师,研究生导师,主要从事临床免疫和生化检验及相关疾病的研究,E-mail:dongsuanzhi@163.com。 通讯作者:王悦喜(1963-),医学博士。
更新日期/Last Update: 2016-06-25