中华妇产科杂志
中華婦產科雜誌
중화부산과잡지
CHINESE JOUNAL OF OBSTETRICS AND GYNECOLOGY
2010年
8期
567-570
,共4页
李轶%魏莉娜%熊永崂%梁晓燕
李軼%魏莉娜%熊永嶗%樑曉燕
리질%위리나%웅영로%량효연
多囊卵巢综合征%促黄体激素%卵泡刺激素%抗苗勒管激素
多囊卵巢綜閤徵%促黃體激素%卵泡刺激素%抗苗勒管激素
다낭란소종합정%촉황체격소%란포자격소%항묘륵관격소
Polycystic ovary syndrome%Luteinizing hormone%Follicle stimulating hormone%Anti-mullerian hormone
目的 比较不同血清黄体生成素(LH)与卵泡刺激素(FSH)比值(LH/FSH)的多囊卵巢综合征(PCOS)患者的抗苗勒管激素(AMH)分泌特点及卵泡发育障碍机制.方法 以LH/FSH为标准,将95例PCOS患者分为高比值组(49例,LH/FSH≥2),常比值组(46例,LH/FSH<2),以62例月经周期规则的输卵管性不孕患者为对照(对照组).3组患者均测定体质指数(BMI);采用酶联免疫吸附试验(ELISA)测定血清AMH水平;采用化学发光法测定血清生殖激素、空腹血糖、胰岛素及血脂水平;采用单因素方差分析法比较各组间生化代谢指标的差异;并运用简单相关分析法和多重线性回归法分析AMH水平与各生化代谢指标的关系.结果 (1)血清AMH水平:高比值组为(7.2±4.3)μg/L,常比值组为(5.2±3.8)μg/L,对照组为(3.7±2.2)μg/L,3组分别比较,差异均有统计学意义(P<0.01).(2)血清AMH水平与生化代谢指标的相关性:高比值组患者血清AMH水平与雌二醇水平呈负相关关系(r=-0.318);常比值组患者血清AMH水平与BMI、空腹血糖、稳态模型胰岛索抵抗指数(HOMA-IR)呈正相关关系(r=0.493、0.362、0.303).控制其他因素影响后,高比值组患者血清AMH水平与LH/FSH呈正相关关系(r=0.301),与雌二醇水平呈负相关关系(r=-0.429);常比值组患者血清AMH水平与BMI呈正相关关系(r=0.493).结论 高LH/FSH的PCOS患者卵泡发育障碍机制可能以下丘脑-垂体功能障碍为主,正常LH/FSH的PCOS患者则以代谢紊乱为主.
目的 比較不同血清黃體生成素(LH)與卵泡刺激素(FSH)比值(LH/FSH)的多囊卵巢綜閤徵(PCOS)患者的抗苗勒管激素(AMH)分泌特點及卵泡髮育障礙機製.方法 以LH/FSH為標準,將95例PCOS患者分為高比值組(49例,LH/FSH≥2),常比值組(46例,LH/FSH<2),以62例月經週期規則的輸卵管性不孕患者為對照(對照組).3組患者均測定體質指數(BMI);採用酶聯免疫吸附試驗(ELISA)測定血清AMH水平;採用化學髮光法測定血清生殖激素、空腹血糖、胰島素及血脂水平;採用單因素方差分析法比較各組間生化代謝指標的差異;併運用簡單相關分析法和多重線性迴歸法分析AMH水平與各生化代謝指標的關繫.結果 (1)血清AMH水平:高比值組為(7.2±4.3)μg/L,常比值組為(5.2±3.8)μg/L,對照組為(3.7±2.2)μg/L,3組分彆比較,差異均有統計學意義(P<0.01).(2)血清AMH水平與生化代謝指標的相關性:高比值組患者血清AMH水平與雌二醇水平呈負相關關繫(r=-0.318);常比值組患者血清AMH水平與BMI、空腹血糖、穩態模型胰島索牴抗指數(HOMA-IR)呈正相關關繫(r=0.493、0.362、0.303).控製其他因素影響後,高比值組患者血清AMH水平與LH/FSH呈正相關關繫(r=0.301),與雌二醇水平呈負相關關繫(r=-0.429);常比值組患者血清AMH水平與BMI呈正相關關繫(r=0.493).結論 高LH/FSH的PCOS患者卵泡髮育障礙機製可能以下丘腦-垂體功能障礙為主,正常LH/FSH的PCOS患者則以代謝紊亂為主.
목적 비교불동혈청황체생성소(LH)여란포자격소(FSH)비치(LH/FSH)적다낭란소종합정(PCOS)환자적항묘륵관격소(AMH)분비특점급란포발육장애궤제.방법 이LH/FSH위표준,장95례PCOS환자분위고비치조(49례,LH/FSH≥2),상비치조(46례,LH/FSH<2),이62례월경주기규칙적수란관성불잉환자위대조(대조조).3조환자균측정체질지수(BMI);채용매련면역흡부시험(ELISA)측정혈청AMH수평;채용화학발광법측정혈청생식격소、공복혈당、이도소급혈지수평;채용단인소방차분석법비교각조간생화대사지표적차이;병운용간단상관분석법화다중선성회귀법분석AMH수평여각생화대사지표적관계.결과 (1)혈청AMH수평:고비치조위(7.2±4.3)μg/L,상비치조위(5.2±3.8)μg/L,대조조위(3.7±2.2)μg/L,3조분별비교,차이균유통계학의의(P<0.01).(2)혈청AMH수평여생화대사지표적상관성:고비치조환자혈청AMH수평여자이순수평정부상관관계(r=-0.318);상비치조환자혈청AMH수평여BMI、공복혈당、은태모형이도색저항지수(HOMA-IR)정정상관관계(r=0.493、0.362、0.303).공제기타인소영향후,고비치조환자혈청AMH수평여LH/FSH정정상관관계(r=0.301),여자이순수평정부상관관계(r=-0.429);상비치조환자혈청AMH수평여BMI정정상관관계(r=0.493).결론 고LH/FSH적PCOS환자란포발육장애궤제가능이하구뇌-수체공능장애위주,정상LH/FSH적PCOS환자칙이대사문란위주.
Objective To investigate characteristics of anti-Müllerian hormone (AMH) secretion and mechanism of aberrant folliculogenesis by the ratio of luteinizing hormone (LH)/follicle-stimulating hormone(FSH) in polycystic ovarian syndrome (PCOS) patients. Methods Base on the ratio of LH/FSH,total 95 patients with PCOS were divided into two groups,including 49 cases in higher ratio group (LH/FSH≥2) and 46 cases in normal ratio group (LH/FSH < 2) matched with 62 infertile cases with tubal factor and regular menstruation as control group. Body mass index (BMI) were calculated in all objectives. The serum AMH were detected by enzyme linked immunosorbent assay(ELISA). Ovarian sexual hormones,fasting blood glucose, insulin and lipid were measured by chemiluminescence method. The correlation between AMH and metabolic index was analyzed by multilinear regression. Results (1) AMH: the serum level of AMH were (7.2±4. 3) μg/L in higher LH/FSH group, (5. 2±3. 8) μg/L in normal LH/FSH group and (3.7 ±2. 2) μg/L in control group, which all reached significant difference among those 3 groups(P < 0. 01). (2) The correlation between AMH and biological metabolic index: estradiol (E2) was negatively correlated with serum level of AMH in higher LH/FSH ratio group (r = -0. 318). The serum level of AMH were positively correlated with BMI, fasting glucose, homeostasis model assessment insulin resistance index (HOMA-IR) in normal LH/FSH ratio group (r = 0. 493,0. 362,0.303). After controlling affect factors, serum levels of AMH were positively correlated with LH/FSH in higher LH/FSH ratio group (r = 0. 301), but negatively correlated with E2 (r = -0. 429). However, in normal LH/FSH group, serum level of AMH was only positively correlated with BMI (r = 0. 428). Conclusion The PCOS patients with higher LH/FSH ratio are primarily caused by hypothalamic-pituitary dysfunction, while the PCOS patients with normal LH/FSH ratio are mainly caused by metabolic disorders.
