AMH、FSH、LH、E2联合检测在不孕症患者卵巢储备功能中的预测价值

摘要

Objective To explore the predictive value of combined detection of AMH,FSH,LH and E2 in the ovarian reserve function of infertile patients.Methods One hundred and seventy-eight cases of infertility receiving vitro fertilization and embryo transfer(IVF-ET) in our hospital from December 2015 to August 2016 were selected and divided into the normal ovarian response group and low ovarian response group according to the number of obtained follicles.The ovarian reserve parameters values were compared between the two groups.The receiver operating characteristic(ROC) curve was used to calculate the area under the curve (AUC) of bE2,bFSH,AMH,bFSH/bLH and combined prediction for evaluating the ovarian response and analyze the sensitivity and specificity of ROC curve in each indicator.Results There was no significant difference between the two groups in the infertility age and bE2 level(P＞0.05).The age,bFSH/bLH value and bFSH levels in the low ovarian response group were higher than that in the normal group,and the difference was statistically significant(P＜0.05);AMH,AFC and number of obtained oocytes in the normal ovarian group were significantly higher than those in the low response group,the difference was statistically significant (P＜ 0.05).The AUC values of bE2,bFSH,bFSH/bLH,AM H,and combined forecasting were (0.57 ± 0.04),(0.64± 0.11),(0.71 ± 0.08),(0.82 ± 0.15) and (0.92 ± 0.12) respectively,the difference was statistically significant (P ＜ 0.05),the AUC value of bE2 had no statistically significant difference(P＞0.05).The specificities were 52.61％,64.34％,68.43％ and 81.64％ respectively,and the sensitivities were 57.93％,61.77 ％,77.68 ％,87.25 ％ and 92.79 ％ respectively.Conclusion The combined detection of AMH,FSH,LH and E2 has an important value for predicting the ovarian reserve function in infertile patients,which can be widely used in clinical practice.%目的 研究抗苗勒管激素(AMH)、促卵泡激素(FSH)、黄体生成素(LH)和雌激素(E2)联合诊断在不孕症患者卵巢储备功能中的预测价值.方法 选取2015年12月至2016年8月接受人工授精的不孕患者178例,根据获取卵泡的数目将患者分为卵巢正常反应组和卵巢低反应组,对比两组间卵巢储备参数值,采用受试者工作特征(ROC)曲线计算基础雌二醇(bE2)、基础促卵泡激素(bFSH)、基础黄体生成素(bLH)、bFSH/bLH、AMH以及联合预测的曲线下面积(AUC),评价卵巢反应性并分析各个指标ROC曲线的灵敏度和特异度.结果 两组患者在不孕年限、bE2水平上差异无统计学意义(P＞0.05),卵巢低反应组患者的年龄、bFSH/bLH、bFSH水平高于正常组,且差异有统计学意义(P＜0.05);卵巢正常反应组AMH、AFC、获卵数高于低反应组,差异有统计学意义(P＜0.05).bE2、bFSH、bFSH/bLH、AMH以及联合预测的AUC值分别为0.57±0.04、0.64±0.11、0.71±0.08、0.82士0.15、0.92±0.12,除bE2的AUC值差异无统计学意义(P＞0.05),其余的AUC值均大于参考线,差异有统计学意义(P＜0.05),特异度分别为52.61％、64.34％、68.43％、81.64％,灵敏度分别为57.93％、61.77％、77.68％、87.25％、92.79％.结论 AMH、FSH、LH、E2联合检测在不孕症患者卵巢储备功能预测中具有重要的价值,可在临床中广泛应用.