抗缪勒管激素、抑制素B及性激素水平对儿童性腺发育异常的诊断价值
作者: |
1李正秋,
2何军,
1刘云花,
3赵莎,
1莫丽亚
1 湖南省儿童医院检验中心,长沙 410007 2 湖南省儿童医院泌尿外科,长沙 410007 3 湖南省儿童医院儿童保健科,长沙 410007 |
通讯: |
莫丽亚
Email: mly7432@aliyun.com |
DOI: | 10.3978/j.issn.2095-6959.2021.02.012 |
摘要
目的:探讨抗缪勒管激素(anti-Mullerian hormone,AMH)、抑制素B(inhibin B,INH-B)及性激素水平对儿童性腺发育异常的诊断意义。方法:选取2019年1月至2019年6月在湖南省儿童医院体检且行血清学检查的儿童共150例,按最后确诊是否儿童性腺发育异常分为性腺发育异常组(n=101)和对照组(n=49)。采用单因素分析性腺发育异常患儿的血清学标志物表达特征,采用logistic回归分析儿童性腺发育异常的独立预测因素,用独立预测因素构建预测儿童性腺发育异常可能的回归方程模型,采用受试者工作特征曲线分析本模型对儿童性腺发育异常的诊断效能。结果:性腺发育异常组儿童血清AMH、INH-B、T水平显著高于对照组,差异具有统计学意义(P<0.05);性腺发育异常组血清LH、FSH、E2、PRL水平显著低于对照组,差异具有统计学意义(P<0.05)。Logistic回归分析显示,AMH、INH-B、E2是儿童性腺发育异常的独立预测因素。本模型最佳截点值为85.43,其曲线下面积为0.943,此截点值下本模型对儿童性腺发育异常的敏感度、特异度、阳性预测值、阴性预测值、符合率分别为97.02%、75.51%、89.09%、92.50%、90.00%。结论:本研究构建的logistic回归方程模型对儿童性腺发育异常有较高的准确性及较好的诊断效能,可以作为辅助筛查的工具之一。
关键词:
抗缪勒管激素;抑制素B;性激素;儿童性腺发育异常
Diagnostic value of anti-Mullerian hormone, inhibin B and sex hormone levels in children with gonadal dysplasia
CorrespondingAuthor: MO Liya Email: mly7432@aliyun.com
DOI: 10.3978/j.issn.2095-6959.2021.02.012
Abstract
Objective: To discuss the value of anti-Mullerian diagnostic value, inhibin B and sex hormone in children with gonadal dysplasia. Methods: A total of 150 patients who underwent serological examination in our hospital from January 2019 to June 2019 were divided into disorders of sex development (DSD) group (n=101) and Control group (n=49) according to they were diagnosed or not. Expression characteristics of serological markers in disorders of gonad development were analyzed by univariate analysis, and independent predictors of disorders of gonad development were analyzed by logistic regression. A regression equation model was established to predict the possibility of disorders of gonad development by independent predictors, and the diagnostic efficacy of the model was analyzed by using receivers’ operating characteristic curve. Results: Serum levels of AMH, INH-B, T in the DSD group was higher than that in Control group, which was statistically significant (P<0.05). Serum levels of LH, FSH, E2, PRL in the DSD group was lower than that in Control group, which was statistically significant (P<0.05). Logistic regression analysis showed that AMH, INH-B and E2 were independent predictors of disorders of gonad development. The best cut-off value of the model was 85.43, and the area under the curve was 0.943. Under this cut-off value, the sensitivity, specificity, positive predictive value, negative predictive value, and coincidence rate of this model to children with DSD were 97.02%, 75.51%, 89.09%, 92.50%, and 90.00%, respectively. Conclusion: The logistic regression equation model constructed in this study had high diagnostic efficiency for disorders of gonad development and and could be used as one of the auxiliary screening tools.
Keywords:
anti-Mullerian hormone; inhibin B; sex hormones; children with gonadal dysplasia