目的 探讨人激活素A和卵泡抑素在腹膜型,卵巢型及深部浸润型子宫内膜异位症中的临床诊断价值。方法 子宫内膜异位症患者139例,分成腹膜型内异症组28例,卵巢型内异症组61例,深部浸润型内异症组50例,月经规律的健康女性(对照组)75例,均采集外周静脉血,采用酶联免疫测定试剂盒分析血清中激活素A和卵泡抑素。结果 卵巢内异症组激活素A水平[(0.22±0.01)ng/ml]明显高于对照组[(0.17±0.01)ng/ml]、腹膜型内异症组[(0.19±0.01)ng/ml]及深部浸润型内异症组[(0.16±0.02)ng/ml],差异有统计学意义;子宫内膜异位症患者卵泡抑素与对照组比较,差异无统计学意义;深部浸润型内异症组卵泡抑素水平[(1.50±0.17)ng/ml]低于腹膜型内异症组[(2.24±0.42)ng/ml]和卵巢内异症组[(2.34±0.32)ng/ml],差异有统计学意义;激活素A和卵泡抑素诊断卵巢内异症的ROC曲线下面积分别为0.700(95% CI为0.605～0.794)和0.620(95% CI为0.510～0.730),二者联合应用不能提高子宫内膜异位症的诊断特异度和灵敏度。结论 激活素A和卵泡抑素水平在腹膜型内异症和深部浸润型内异症中无明显改变,对诊断卵巢型内异症的准确率有限。
Abstract
Objective To explore the clinical value of activin A and follistatin levels in women with peritoneal, ovarian and deep infiltrating endometriosis. Methods One hundred and thirty-nine patients with endometriosis were divided into three groups: peritoneal endometriosis (n=28), ovarian endometrioma (n=61), and deep infiltrating endometriosis (n=50). Seventy-five health women were included as the control group. Peripheral vein blood samples were collected for activin A and follistatin assessment by enzyme immunoassay kits. Results The ovarian endometrioma group [(0.22±0.01)ng/ml] had serum activin A levels significantly higher than healthy controls [(0.17±0.01)ng/ml]. Serum follistatin levels of all patients with endometriosis did not differ from healthy controls. However, follistatin levels in the endometrioma group [(2.24±0.42)ng/ml] were higher than that in the deep endometriosis group [(1.50±0.17)ng/ml]. The area under the receiver-operating characteristic (ROC) curve of activin A was 0.700 (95% CI: 0.605-0.794), while that of follistatin was 0.620 (95% CI: 0.51-0.73) for the diagnosis of ovarian endometrioma. The combination of the two markers did not improve diagnostic accuracy. Conclusion The present study demonstrated that serum activin A and follistatin are not significantly altered in peritoneal or deepinfiltrating endometriosis and have limited diagnostic accuracy in the diagnosis of ovarian endometrioma.
关键词
激活素A /
卵泡抑素 /
子宫内膜异位症
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Key words
Activin A /
Follistatin /
Endometriosis
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参考文献
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