血清sCD68、AMH、HSP70检测在多囊卵巢综合征诊断及临床转归预测中的应用

Application of serum sCD68, AMH, HSP70 detection in diagnosis and prognosis of polycystic ovary syndrome

摘要:

目的 探讨血清可溶性CD68（sCD68）、抗苗勒管激素（AMH）、热休克蛋白70（HSP70）水平对多囊卵巢综合征（PCOS）的诊断效能及在预测转归中的应用价值。方法 选取2021年6月至2023年4月南阳市第一人民医院230例PCOS患者为研究对象，根据月经情况分为轻度组、中度组及重度组，另选取70例健康体检者为对照组。对比4组治疗前血清sCD68、AMH、HSP70水平，ROC分析治疗前血清各指标联合检测对PCOS的诊断价值，对比不同预后患者治疗前、治疗4周后血清各指标水平及临床资料，Logistic回归分析PCOS患者预后不良的危险因素，分析血清各指标不同水平患者预后不良的危险度。结果 治疗前4组血清sCD68、AMH、HSP70水平比较：重度组>中度组>轻度组>对照组（P<0.05），治疗前血清sCD68、AMH、HSP70联合检测诊断PCOS的曲线下面积（AUC）为0.736。治疗前预后良好患者卵泡数、卵巢体积低于预后不良患者，治疗前及治疗4周后预后不良患者sCD68、AMH、HSP70水平均高于预后良好患者（P<0.05）。Logistic回归分析卵泡数、卵巢体积及血清sCD68、AMH、HSP70为PCOS患者预后不良的危险因素（P<0.05），治疗前及治疗4周后血清sCD68、AMH、HSP70高水平患者发生预后不良是低水平的数倍（P<0.05）。结论 血清sCD68、AMH、HSP70水平检测对临床诊断PCOS具有重要应用价值，同时可作为预测转归的有效血清因子。

Abstract:

Objective To investigate the diagnostic efficacy of serum soluble CD68 (sCD68), anti-Mulleran-tube hormone (AMH) and heat shock protein 70 (HSP70) levels in polycystic ovary syndrome (PCOS) and their application value in prognosis.Methods A total of 230 patients with PCOS in Nanyang First People's Hospital from June 2021 to April 2023 were selected as the study objects, and were divided into mild group, moderate group and severe group according to menstruation, and 70 healthy subjects were selected as the control group. The serum levels of sCD68, AMH and HSP70 were compared before treatment. ROC analysis of the diagnostic value of serum indexes combined detection before treatment for PCOS. The serum levels and clinical data of patients with different prognosis were compared before treatment and 4 weeks after treatment. Logistic regression analysis was performed to analyze the risk factors of poor prognosis in PCOS patients. The risk of poor prognosis of patients with different levels of serum indexes was analyzed.Results Before treatment, the levels of serum sCD68, AMH and HSP70 in 4 groups were compared: severe group > moderate group > mild group > control group (P<0.05). The AUC of serum sCD68, AMH and HSP70 for diagnosis of PCOS before treatment was 0.736. Before treatment follicle number and ovarian volume in patients with good prognosis were lower than those with poor prognosis, sCD68, AMH and HSP70 levels in patients with poor prognosis were higher than those in patients with good prognosis before and 4 weeks after treatment (P<0.05). Logistic regression analysis showed that follicle number, ovarian volume and serum sCD68, AMH and HSP70 were the risk factors for poor prognosis in PCOS patients (P<0.05). The poor prognosis of patients with high levels of serum sCD68, AMH and HSP70 before and after 4 weeks of treatment was several times higher than those with low levels (P<0.05).Conclusion Serum sCD68, AMH, HSP70 levels have important application value in clinical diagnosis of PCOS, and can be used as an effective serum factor to predict the outcome.