目的 探讨血清脂联素（ADPN）、糖类抗原125（CA125）及抗苗勒管激素（AMH）水平检测在多囊卵巢综合征（PCOS）中的临床诊断价值。方法 选取2022年1月—2022年9月在东莞市中医院经鹿特丹诊断标准确诊的100例PCOS患者作为PCOS组;PCOS组通过测定患者体质量指数（BMI）是否大于28 kg/m²分为肥胖组和非肥胖组;测定患者的睾酮水平的高低是否大于80 ng/dL分为高雄激素组和非高雄激素组。另选身体健康、年龄与PCOS组相近的100名健康女性作为对照组。分别测定PCOS组和对照组的ADPN、CA125以及AMH,分析血清ADPN、CA125、AMH在PCOS患者中的检测价值。结果 POCS组的BMI、AMH、CA125、睾酮、ADPN与健康组比较差异均有统计学意义（P<0.05）。与对照组比较,PCOS组的BMI、AMH、CA125、睾酮水平升高、ADPN水平降低。PCOS患者的CA125与AMH水平呈正相关（P<0.05）,ADPN与AMH无关（P>0.05）。结论 PCOS 患者血清CA125和AMH水平升高,ADPN水平降低。

Objective To explore the clinical diagnostic value of serum adiponectin（ADPN）,carbohydrate antigen 125（CA125）and anti-Mullerian hormone（AMH）levels in polycystic ovary syndrome（PCOS）．Method A total of 100 patients confirmed with PCOS in Dongguan Traditional Chinese Medicine Hospital from January 2022 to September 2022 were selected as the study subjects．All patients were diagnosed with PCOS according to the 2003 Rotterdam diagnostic criteria,and served as the PCOS group．The PCOS group was divided into obese and non obese group by measuring the patient’s body mass index（BMI）whether was greater than 28 kg/m²．A high androgen group and a non high androgen group were determined by whether the patient’s testosterone level is greater than 80 ng/dL．A hundred healthy women of similar age were selected as the healthy control group．The levels of ADPN,CA125 and AMH were measured in the experimental and control group,and their detection value were analyzed．Results BMI,AMH,CA125,testosterone and ADPN in the POCS group were statistically different compared to the healthy group（P<0.05）．Compared with the PCOS group,the control group showed a significant increase in BMI,AMH,CA125 and testosterone levels,while the PCOS group showed a decrease in ADPN level．There was a positive correlation between CA125 and AMH in patients with PCOS,while there was no correlation between ADPN and AMH．Conclusions The levels of serum CA125 and AMH in PCOS patients significantly increased,while the level of ADPN decreased．The three indicators have good diagnostic value in PCOS and are worth promoting．

目的 探讨青春期多囊卵巢综合征(PCOS)患者血清抗苗勒管激素(AMH)与25(OH)D₃水平的相关性。方法 本研究选择在2019年1月—2020年12月在我院妇科门诊就诊的PCOS青春期女性79名,另选择同期体检的非PCOS健康对照85名。对所有受试者测量身高、体质量,计算体质量指数(BMI)。由诊治医生检查研究对象是否有痤疮、多毛以及月经情况。抽取静脉血检测黄体生成素、卵泡刺激素、总睾酮、硫酸脱氢表雄酮、抗苗勒管激素和 25(OH)D₃,将 25(OH)D₃分为不足[25(OH)D₃<30 ng/mL]和缺乏[25(OH)D₃<20 ng/mL]2组,对数据进行比较分析。结果 与健康对照组比较,PCOS组更容易发生月经稀发/闭经,其痤疮发生率较高(P值均<0.05)。体质量指数、AMH值、总睾酮和硫酸脱氢表雄酮的体内检出水平在PCOS组较高,而25(OH)D₃在PCOS组较低(P值均<0.05)。PCOS组的AMH与BMI和总睾酮呈正相关关系,与25(OH)D₃呈负相关关系(P值均<0.05)。25(OH)D₃缺乏组的AMH水平高于25(OH)D₃不足组,对照组和PCOS组的25(OH)D₃缺乏组的AMH水平均高于25(OH)D₃不足组,两两比较其差异有统计学意义(P值均<0.05)。健康对照组的25(OH)D₃缺乏率为67.1%(57/85),而PCOS组的25(OH)D₃缺乏率为96.2%(76/79),2组比较其差异有统计学意义(χ²=22.68,P<0.001)。结论 青春期多囊卵巢综合征患者体内 25(OH)D₃水平与AMH 水平显著相关。AMH 和25(OH)D₃可用于评估青春期PCOS发病风险的替代指标。

Objective To explore the correlation between serum anti-Müllerian hormone (AMH) and 25(OH)D₃ levels in adolescent patients with polycystic ovary syndrome (PCOS). Methods Seventy-nine adolescent girls with PCOS and 85 non-PCOS healthy controls who walked in the gynecological clinic of our hospital from January 2019 to December 2020 were selected. Height, weight were measured and body mass index (BMI) was calculated.Hirsutism, acne and menstruation were evaluated by doctors on all subjects. Venous blood was drawn to detect levels of luteinizing hormone, follicle stimulating hormone, total testosterone, dehydroepiandrosterone sulfate, AMH and 25(OH)D₃, 25(OH)D₃ was further divided into insufficient [25(OH)D₃<30 ng/mL] and deficient [25(OH)D₃<20 ng/mL]level, then all data were compared and analyzed between two groups. Results Compared with the healthy control group, the PCOS group was more prone to have oligomenorrhea or amenorrhea, the incidence of acne was higher in PCOS group than in control group (all P values<0.05). BMI, the levels of AMH, total testosterone and dehydroepiandrosterone sulfate were significantly higher in the PCOS group compared to the control group, while 25(OH)D₃ was the opposite (all P values <0.05). AMH in the PCOS group was positively correlated with BMI and level of total testosterone, and negatively correlated with 25(OH)D₃ (all P values<0.05). The AMH level in the 25(OH)D₃ deficiency group was higher than that in the 25(OH)D₃ insufficient group, the AMH levels of the 25(OH)D₃ deficient group and control group were higher than that in the 25(OH)D₃ insufficient group,the differences were statistically significant (P<0.05). The 25(OH)D₃ deficiency rate in the healthy control group was 67.1% (57/85), while the 25(OH)D₃ deficiency rate in the PCOS group was 96.2% (76/79). The difference between the two groups was statistically significant (χ²=22.68, P<0.001). Conclusions Serum 25(OH)D₃ level was an independent factor significantly associated with AMH level in adolescents with PCOS. AMH and 25(OH)D₃ levels may be used as surrogate markers of PCOS risk in adolescents.

目的 探讨腹腔镜下输卵管积水既往手术史对血清AMH和卵巢储备功能的影响。方法 选择2016年1月—2016年12月期间在中山市博爱医院生殖内分泌科就诊拟行体外受精—胚胎移植术患者,按照既往的输卵管积水的不同处理方式将患者分为腹腔镜下双侧输卵管切除术组(A组,n=52)、腹腔镜下双侧输卵管开窗术组(B组,n=71)、双侧输卵管阻塞或通而不畅而无积水组(C组,n=96),比较各组在促排卵首日AMH、以及AFC、FSH、LH、E2、孕酮的差异,比较各组Gn治疗时间和用量,以及注射HCG日的成熟卵泡数的差异。结果 A组的AMH、LH低于B组和C组(P<0.05),而B组和C组间AMH、LH差异无统计学意义(P>0.05)。A组AFC水平低于C组(P<0.05),而E2水平高于C组(P<0.05)。A组的FSH高于B组和C组(P<0.05),B组和C组间FSH差异无统计学意义(P>0.05)。三组间孕酮差异无统计学意义(P>0.05)。A组的注射HCG日的成熟卵泡数低于B组和C组(P<0.05),而B组和C组间成熟卵泡数差异无统计学意义(P>0.05)。A组Gn用量高于B组和C组(P<0.05),而B组和C组间Gn用量差异无统计学意义(P>0.05)。三组间Gn治疗时间差异无统计学意义(P>0.05)。结论 通过AMH等指标检测,腹腔镜输卵管切除术会降低患者的卵巢储备功能,而开窗术则影响相对较小,对有生育要求的妇女应考虑行输卵管开窗术等方式以保护卵巢功能。