我院育龄妇女血清睾酮水平正常值范围的修正及其对PCOS诊断的影响

目的:修正高雄激素血症的诊断标准,并分析其对PCOS诊断标准的影响。方法:以3 545例无排卵障碍和无内分泌疾病的育龄妇女为正常排卵组,测定其睾酮(T)水平,并根据测定值修正T水平的正常值范围,按修正的正常值范围通过1 248例PCOS患者分析其对PCOS诊断标准及分型的影响。结果:①正常排卵组和PCOS组的年龄、FSH、E2组间比较差异无统计学意义(P0.05),而BMI、LH、T组间比较差异有统计学意义(P0.05)。根据正常排卵组的T水平确定其正常值范围为0.27±0.23(0.04~0.50)ng/ml,修正后T0.65 ng/ml即可诊断为生化高雄激素血症。②修正雄激素的正常值范围后,PCOS组高雄激素血症的比例有明显提高,PCOS 4个亚型构成比有变化,有359例Ⅱ型PCOS患者转为Ⅰ型PCOS。结论:我院育龄女性雄激素水平的正常值范围需要修正,修正的雄激素正常值范围对PCOS的诊断及分型有影响。

Amended the Normal Range of Serum Testosterone Level in Women of Reproductive Age and Its Impact on the PCOS Diagnosis in Our Hospital

Objective： To amend the diagnostic criteria of hyperandrogenism and analyze the impact on the PCOS diagnosis. Methods： A total of 4 793 infertility women were divided into normal ovulation group （n= 3 545） and PCOS group （n=1 248）. The normal range of serum testosterone （T） level was amended according to the normal ovulation group, and the impact on diagnosis of PCOS and its subtypes were analyzed. Results： 1） There were no significant differences in age, FSH, E2 between normal ovulation group and PCOS group （P〉0.05）, and there were significant differences in BMI, LH, T between the two groups （P〈0.05）. Amended the normal range of T level in normal ovulation group 0.27 ± 0.23 （0.04-0.50） ng/ml], T〉0.65 ng/ml was the diagnostic criteria of hyperandrogenism. 2） The hyperandrogenism ratio increased in PCOS group according to the amended T level, the proportion of four subtypes PCOS changed, there were 359 type II PCOS patients changed into type I. Conclusion： The normal range of androgen level in reproductive women in our hospital need to be amended, and it affects the diagnosis of PCOS and its subtypes.