摘要
目的探讨血清抗苗勒管激素(AMH)联合经阴道彩色多普勒超声(简称阴道彩超)对不孕症患者卵巢储备功能的预测价值。方法以德州市人民医院2018年1月至2020年10月诊治的105例不孕症患者为研究对象, 其中首次检查获卵数不足5个(卵巢低反应)32例, 纳入A组, 获卵数5 ~ 15个(卵巢正常反应)73例, 纳入B组。比较A、B组和年龄>35岁与年龄≤35岁组血清AMH水平、窦卵泡数(AFC)、卵巢体积(OV)、卵巢间质动脉峰值流速(PSV)的差异, 分析血清AMH水平与年龄、超声参数的关系, 应用受试者工作特征(ROC)曲线分析血清AMH水平联合AFC、OV、PSV对卵巢低反应的评估效能。结果 A组血清AMH水平、AFC、OV、PSV均低于B组[(0.69 ± 0.28) μg/L比(1.43 ± 0.44) μg/L、(8.52 ± 2.29)个比(11.15 ± 2.56)个、(3.12 ± 0.70) cm3比(4.50 ± 1.31) cm3、(8.80 ± 2.14) cm/s比(15.80 ± 4.43) cm/s], 差异有统计学意义(P<0.05)。年龄>35岁组血清AMH水平、AFC、OV、PSV均低于年龄≤ 35岁组[(0.64 ± 0.20) μg/L比(1.71 ± 0.46) μg/L、(8.35 ± 2.68)个比(12.17 ± 2.79)个、(3.05 ± 0.78) cm3比(5.02 ± 1.26) cm3、(9.01 ± 3.04) cm/s比(17.90 ± 4.19) cm/s], 差异有统计学意义(P<0.05);血清AMH水平与年龄呈负相关(r = - 0.317, P<0.05), 与AFC、OV、PSV均呈正相关(r = 0.288、0.326、0.370, 均P<0.05)。AMH + AFC + OV + PSV评估卵巢低反应的灵敏度、特异度为96.90%、100.00%。结论血清AMH联合阴道彩超对不孕症患者卵巢储备功能评估的灵敏度、特异度均较高。
Objective To investigate the predictive value of serum anti-Mullerian hormone(AMH)combined with transvaginal color Doppler ultrasonography(vaginal color ultrasound)for ovarian reserve function in infertility patients.Methods A total of 105 infertility patients diagnosed and treated in Dezhou People′s Hospital from January 2018 to October 2020 were selected as study subjects.Among them,32 patients with less than 5 eggs obtained after the first treatment(low ovarian response)were included in group A,and 73 patients with 5 to 15 eggs obtained(normal ovarian response)were included in group B.Serum AMH levels were measured,antral follicle count(AFC),ovarian volume(OV),and ovarian stromal peak diastolic systolic velocity(PSV)were recorded by vaginal ultrasound.The levels of above index in A,B groups,patients aged>35 years old,and those aged≤35 years old were compared.Moreover,the correlation among serum AMH level and aged,ultrasonic parameters were analyzed.The efficacy of serum AMH level and AFC,OV and PSV in predicting low ovarian response was analyzed by receiver operating characteristic(ROC)curve.Results The levels of serum AMH,AFC,OV and PSV in group A were lower than those in group B:(0.69±0.28)μg/L vs.(1.43±0.44)μg/L,(8.52±2.29)eggs vs.(11.15±2.56)eggs,(3.12±0.70)cm3 vs.(4.50±1.31)cm3,(8.80±2.14)cm/s vs.(15.80±4.43)cm/s,the differences were statistically significant(P<0.05).The levels of serum AMH,AFC,OV and PSV in aged>35 years old group were lower than those in aged≤35 years old group:(0.64±0.20)g/L vs.(1.71±0.46)μg/L,(8.35±2.68)eggs vs.(12.17±2.79)eggs,(3.05±0.78)cm3 vs.(5.02±1.26)cm3,(9.01±3.04)cm/s vs.(17.90±4.19)cm/s,the differences were statistically significant(P<0.05).Serum AMH level was negatively correlated with age(r=-0.317,P<0.05),and positively correlated with AFC,OV and PSV(r=0.288,0.326,0.370,P<0.05).The sensitivity and specificity for the evaluation of low ovarian response by AMH+AFC+OV+PSV were 96.90%and 100.00%respectively.Conclusions The sensitivity and specificity of
作者
张志洁
范静
王卿
仲晓红
Zhang Zhijie;Fan Jing;Wang Qing;Zhong Xiaohong(Department of Ultrasonography,Dezhou People′s Hospital,Dezhou 253000,China;Department of Clinical Laboratory,Dezhou People′s Hospital,Dezhou 253000,China)
出处
《中国医师进修杂志》
2022年第2期123-126,共4页
Chinese Journal of Postgraduates of Medicine
