中文摘要：

目的：比较抗苗勒管激素（AMH）在高雄激素和非高雄激素型多囊卵巢综合征（PCOS）患者的分泌特点和诊断效能，对发病机制进行探讨。方法：纳入具有排卵障碍的PCOS患者131例（高雄组62例，非高雄组69例），另外纳入61例输卵管或男方因素不孕的患者为对照组。采用酶联免疫吸附法和化学发光法检测并比较3组患者血清中AMH、性激素、糖脂代谢等生化指标，采用ROC曲线评估AMH对PCOS患者的诊断效能；采用Pearman＇s相关法分析高雄和非高雄型PCOS患者血清AMH水平与其他各参数间的关系。结果：①PCOS患者血清AMH水平显著高于对照组（P〈0．05），高雄组又显著高于非高雄组（P〈0．05）。②AMH诊断高雄组PCOS患者的AUC为0．82，敏感性为82％，特异性为64％。AMH诊断非高雄组PCOS患者的AUC为0．66，敏感性为64％，特异性为62％。③高雄组PCOS患者AMH与FSH呈负相关（r=-0．42，P=0．05），与LH呈正相关（r=0．46，P〈0．05）。非高雄组PCOS患者AMH与HDL呈负相关（r=-0．28，P〈0．05），与BMI、空腹血糖和LDL呈正相关（r=0．26；r=0．27；r=0．29，P〈0．05）。结论：AMH适合于诊断某种特定亚型如高雄激素型PCOS，对非高雄激素型PCOS的诊断准确性较低，由此也反映出两种亚型患者发病机制可能存在差异。

英文摘要：

Objective：To compare the secretory profiles and diagnostic power of anti-Mullerian hormone （AMH） for the PCOS patient with and without hyperandrogenism. Methods ：131 PCOS patients with oligo- menorrhea or amenorrhea（62 for hyperandrogenism （ HA ＋ ）and 69 for hyperandrogenism （HA-） were recrui- ted into the study as study group;61 infertility patients because of oviduct factors were included as control group. Pearman＇s analysis were used to evaluate the relationship between the levels of AMH and basal sexu- al hormones,glucose and lipid metabolic indicators. Results：①The AMH serum levels of PCOS patients were significantly higher than those of control group,with the highest AMH serum level in the HA ＋ group.②The area under curve for predicting PCOS patients in the HA ＋group was 0. 82, with a sensitivity of 82%, and specificity of 64%. The area under curve for predicting PCOS patients in the HA-group was 0.66,with a sen- sitivity of 64%, and specificity of 62%. ③ln the HA ＋ group, AMH was negatively associated with FSH （ r = - 0. 42, P = 0.05） and positively associated with LH （ r = - 0.46, P 〈 0.05 ）. In the HA-group, AMH was negatively associated with HDL（ r = -0, 28, P 〈 0.05）and positively associated with BMI ,fasting glucose andLDL（r=0.26;r=0.27;r=0.29,P〈0.05）. Conclusions：AMH is only suitable for predicting the PCOS pa- tients with hyperandrogenism. The diagnostic power of AMH is limited when used to predict patients without hyperandrogenism,which to some degree reflects the differences in pathophysiology between the two sub- types.