摘要目的 探讨血清抗苗勒管激素(AMH)值诊断多囊卵巢综合征(PCOS)界值及在控制性超排卵(COH)过程中对卵巢高反应的预测性.方法 共计535例患者纳入研究,其中PCOS组290例,对照组245例,按年龄分4层,留取基础性激素[睾酮(T)、孕酮(P)、卵泡刺激素(FSH)、黄体生成素(LH)、雌激素(E2)]及AMH进行分析比较.共对138例患者采用拮抗剂方案行IVF/ICSI助孕,其中PCOS组66例,对照组71例.通过对基础AMH、体质量指数(BMI)、促性腺激素(GN)剂量、用药时间、扳机日P、人体绒毛膜促性腺激素(HCG)日LH、HCG日E2等分析,比较AMH对卵巢高反应的预测价值.结果 AMH作为诊断PCOS的标准,两组比较差异具有统计学意义(P<0.001).全年龄组Cut-off值为5.94 ng/mL,敏感度为0.738,特异度为0.747.AMH与卵巢高反应成中等强度正相关(r=0.498,P<0.001).AMH对卵巢高反应的预测界值为5.72 ng/ml(P<0.05),敏感度为0.714,特异度为0.833.AMH对PCOS患者卵巢高反应的预测界值为9.74 ng/ml(P<0.05),敏感度为0.833,特异度为0.727.结论 AMH对于PCOS诊断有一定价值,并且可以作为预测PCOS患者卵巢高反应的指标.

abstractsObjective To investigate the diagnostic value of serum anti Mullerian hormone ( AMH) value in the diagnosis of polycystic ovary syndrome( PCOS) and the prediction of ovarian hyper re-sponse during controlled ovarian hyperstimulation( COH) . Methods A total of 535 people were enrolled in the study,including PCOS group(n=290)and control group(n=245). The patients were divided into four groups according to age,and the basic hormones(T,P,LH,FSH,E2)ands erum AMH were compared. A to-tal of 138 people were treated with IVF/ICSI,and the control group was 71 people,with a total of 66 people in the PCOS group. Through the analysis of AMH,BMI,GN dosage,medication time,HCG day P,HCG day LH,HCG day E2,the predictive value of AMH in high ovarian response was compared. Results AMH as the diagnostic criteria of PCOS was statistically significant(P<0. 001). Cut-off value of the whole age group was 5. 94 ng/mL,sensitivity was 0. 738,specificity was 0. 747. AMH was positively correlated with ovarian high response to moderate intensity(r=0. 498,P<0. 001). The predictive value of AMH for ovarian hyper response was 5. 72 ng/mL(P<0. 05),with a sensitivity of 0. 714 and a specificity of 0. 833. The predictive value of AMH for ovarian hyper response in patients with PCOS was 9. 74 ng/ml(P<0. 05),with a sensi-tivity of 0. 833 and a specificity of 0. 727. Conclusion AMH has some value in the diagnosis of PCOS,and can be used as an indicator to predict the ovarian response in PCOS patients.