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目的:探讨多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者高抗苗勒管激素(anti-Müllerian hormone,AMH)水平对人绝经期促性腺激素(h MG)促排卵结局的影响。方法:采用前瞻性研究,分析63例接受h MG促排卵的PCOS患者。比较对h MG有反应与无反应组间的AMH浓度。采用受试者工作特征(receiver operating characteristic,ROC)曲线评估AMH预测卵巢反应性价值。结果:有反应组AMH水平明显低于无反应组(8.43±2.18μg/L vs 11.05±2.85μg/L,P<0.001)。多因素逐步回归分析提示AMH是预测卵巢反应性的唯一指标。ROC曲线分析显示AMH是一项潜在有效的预测卵巢反应性的指标。将血AMH界值10.12μg/L作为判断标准,其预测卵巢对h MG反应的敏感性达91.7%,特异性达66.7%。结论:血清AMH可作为有效的预测PCOS患者对h MG反应性的指标。
OBJECTIVE: To investigate the effect of anti-Müllerian hormone (AMH) levels on the ovulation induction of human menopausal gonadotrophin (h MG) in patients with polycystic ovary syndrome (PCOS). Methods: A prospective study of 63 PCOS patients receiving h MG ovulation induction was performed. The AMH concentrations were compared between responders and non-responders to h MG. The receiver operating characteristic (ROC) curve was used to assess the predictive value of AMH for ovarian response. Results: The level of AMH in response group was significantly lower than that in non-response group (8.43 ± 2.18μg / L vs 11.05 ± 2.85μg / L, P <0.001). Multi-factor stepwise regression analysis showed that AMH was the only predictor of ovarian response. ROC curve analysis showed that AMH is a potentially effective predictor of ovarian response. The blood AMH cutoff value of 10.12 μg / L was used as a criterion to predict the ovarian response to h MG with a sensitivity of 91.7% and a specificity of 66.7%. Conclusion: Serum AMH can be used as an effective predictor of response to h MG in PCOS patients.