CAJ | 학술논문

目的探讨血清黄体生成素(LH)与卵泡刺激素(FSH)的比值对卵巢呈多囊样改变(PCO)患者确诊多囊卵巢综合征(PCOS)的价值,比较欧洲人类生殖与胚胎学会及美国生殖学会的诊断标准(鹿特丹标准)与日本妇产科学会的诊断标准(日本标准)间的差异.方法对195例就诊于南方医科大学南方医院生殖医学中心、阴道B超示PCO的患者,分别按照鹿特丹标准和日本标准进行判别,比较两种标准诊断的PCOS与非PCOS患者之间各项指标间的差异,并通过受试者工作特征(ROC)曲线下面积分析LH、LH/FSH、睾酮等指标在PCOS诊断中的意义;另选择119例非PCO且月经周期正常者作为对照组.结果 195例PCO者中,鹿特丹标准确诊PCOS患者144例,非PCOS患者51;日本标准确诊PCOS患者111例,非PCOS患者84例.鹿特丹标准确诊PCOS患者与非PCOS患者的LH/FSH分别为1.59±0.84和0.85±0.47,日本标准确诊PCOS患者与非PCOS患者的LH/FSH分别为1.87±0.76和0.78±0.39,LH/FSH对鹿特丹标准和日本标准诊断为PCOS进行判别时,ROC曲线下面积分别为0.786和0.942.结论 LH/FSH≥1对PCO者确诊PCOS有重要的参考价值,且日本标准更适合我国PCOS的诊断.
목적 탐토혈청황체생성소(LH)여란포자격소(FSH)적비치대란소정다낭양개변(PCO)환자학진다낭란소종합정(PCOS)적개치,비교구주인류생식여배태학회급미국생식학회적진단표준(록특단표준)여일본부산과학회적진단표준(일본표준)간적차이.방법 대195례취진우남방의과대학남방의원생식의학중심、음도B초시PCO적환자,분별안조록특단표준화일본표준진행판별,비교량충표준진단적PCOS여비PCOS환자지간각항지표간적차이,병통과수시자공작특정(ROC)곡선하면적분석LH、LH/FSH、고동등지표재PCOS진단중적의의;령선택119례비PCO차월경주기정상자작위대조조.결과 195례PCO자중,록특단표준학진PCOS환자144례,비PCOS환자51;일본표준학진PCOS환자111례,비PCOS환자84례.록특단표준학진PCOS환자여비PCOS환자적LH/FSH분별위1.59±0.84화0.85±0.47,일본표준학진PCOS환자여비PCOS환자적LH/FSH분별위1.87±0.76화0.78±0.39,LH/FSH대록특단표준화일본표준진단위PCOS진행판별시,ROC곡선하면적분별위0.786화0.942.결론 LH/FSH≥1대PCO자학진PCOS유중요적삼고개치,차일본표준경괄합아국PCOS적진단.
Objective To investigate the value of ratio of luteinizing hormone (LH) to folliclestimulating hormone (FSH) in diagnosis of polycystic ovarian syndrome (PCOS) among women with ploycystic ovary (PCO) and to compare the difference of the diagnostic criteria between the Rotterdam Consensus and the Committee for Reproductive and Endocrine in Japan Society of Obstetrics and Gynecology.Methods By means of transvaginal Doppler ultrasound, 195 women with PCO were diagnosed in Nanfang Hospital of Reproductive Medicine Center and compare difference of multiple clinical indexes according to Rotterdam consensus and Japan consensus respectively. In the mean time, the ratio of LH/FSH, the level of LH, testosterone (T) and recevier operating characteristic (ROC) curve were explored to on the value of diagnosis of PCOS. Results By Rotterdam consensus, 144 women were diagnosed with PCOS and 51 women were non-PCOS, while 111 were identified as PCOS and 84 were non-PCOS according to Japan consensus. LH/FSH in PCOS and non-PCOS were 1.59 ±0. 84 and 0. 85 ±0. 47 respectively when based on Rotterdam consensus, and this ratio were 1.87 ± 0. 76 in PCOS and 0. 78 ± 0. 39 in non-PCOS based on Japan consensus. When using LH/FSH to diagnosis PCOS by Rotterdam consensus and Japan consensus,areas under ROC curve are 0. 786 and 0. 942, respectively. Conclusions The ratio of LH/FSH ≥ 1 provide the significant value in the diagnosis of PCOS. The criteria of the Committee for Reproductive and Endocrine in Japan Society of Obstetrics and Gynecology is more suitable for Chinese patients.