本文選題：多囊卵巢綜合征 + 游離睪酮指數(shù)　； 參考：《重慶醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:探討多囊卵巢綜合征(polycystic ovarian syndrome,PCOS)患者體內(nèi)游離睪酮指數(shù)(free androgen index,FAI)與胰島素抵抗(insulin resistance,IR)的關(guān)系并對(duì)FAI診斷PCOS患者IR的診斷性能進(jìn)行評(píng)價(jià)。方法:選擇139例PCOS患者作為病例組和100例健康女性作為對(duì)照組,所有受試者進(jìn)行了OGTT試驗(yàn)和測(cè)定了人體基本測(cè)量指標(biāo),酶法分析了血糖、血脂等指標(biāo),化學(xué)發(fā)光免疫法測(cè)定了激素水平,HOMA-IR評(píng)估了IR程度。兩樣本t檢驗(yàn)分析了兩組之間的血清FAI與HOMA-IR的差異,Pearson線性相關(guān)與多元逐步回歸研究了FAI與IR的相關(guān)性,并用二甲雙胍干預(yù)評(píng)價(jià)了FAI的改善狀況,ROC曲線上選取了FAI診斷IR的最佳臨界點(diǎn)并評(píng)價(jià)了FAI的診斷性能,卡方檢驗(yàn)評(píng)價(jià)了FAI與HOMA-IR診斷IR的一致性。結(jié)果:PCOS組的血清FAI與HOMA-IR升高(P=0.00);匹配BMI后,PCOS超重組的血清FAI和HOMA-IR水平更高(P=0.01);Pearson相關(guān)分析顯示,PCOS患者血清FAI與BMI(r=0.42,P=0.001)、HOMA-IR(r=0.46,P=0.00)、FAT(r=0.25,P=0.00)呈正相關(guān),多元逐步回歸分析,PCOS組HOMA-IR和BMI是影響血清FAI水平的獨(dú)立危險(xiǎn)因素;經(jīng)二甲雙胍治療6個(gè)月之后,PCOS患者HOMA-IR改善(P=0.00),FAI也改善(P=0.00);對(duì)于PCOS患者IR的診斷性能,FAI檢測(cè)靈敏度為72.04%,特異度為65.22%,ROC曲線下面積為0.6891,95%CI為0.5941~0.7841;FAI與HMOA-IR的診斷一致率為71.22%(99/139),McNemarχ2檢驗(yàn)結(jié)果分析FAI與HOMA-IR之間差異無統(tǒng)計(jì)學(xué)意義(χ2=1.6,P=0.268)。結(jié)論:PCOS患者體內(nèi)FAI與IR存在正相關(guān)關(guān)系,FAI對(duì)于IR有一定的診斷價(jià)值。
[Abstract]:Objective: to investigate the relationship between free androgen index (FAI) and insulin resistance (IR) in patients with polycystic ovarian syndrome (PCOS) and to evaluate the diagnostic performance of FAI in the diagnosis of PCOS. Methods: 139 patients with PCOS were selected as the case group and 100 healthy women as the control group. All the subjects were tested by OGTT test and the basic human body measurement indexes were measured. The blood glucose, blood lipid and other indexes were analyzed by enzymatic method. The hormone level was determined by chemiluminescence immunoassay and the degree of IR was evaluated by HOMA-IR. The difference of serum FAI and HOMA-IR between the two groups was analyzed by t-test. Pearson linear correlation and multivariate stepwise regression were used to study the correlation between FAI and IR. Metformin intervention was used to evaluate the improvement of FAI. The best critical point of FAI diagnosis was selected and the diagnostic performance of FAI was evaluated on the curve of FAI. Chi-square test was used to evaluate the consistency between FAI and HOMA-IR in the diagnosis of IR. Results the levels of serum FAI and HOMA-IR were significantly higher than those in the control group, and the levels of serum FAI and HOMA-IR were higher in patients with hyperrecombination of BMI. The correlation analysis showed that there was a positive correlation between serum FAI and HOMA-IRR0.46P0.006P0. 25P0. 00in the patients with PCOS (P < 0. 01), and the levels of serum FAI and HOMA-IR were higher than those in patients with BMI (P < 0. 01), and the correlation analysis showed that there was a positive correlation between the levels of serum FAI and BMI-IRR 0. 46P0. 00P = 0. 25p. Multiple stepwise regression analysis showed that HOMA-IR and BMI were independent risk factors for serum FAI level in PCOS group. After 6 months of metformin treatment, the improvement of HOMA-IR in patients with PCOS was also improved. The diagnostic performance of IR in patients with PCOS was 72.04 and the specificity was 65.222.The area under the ROC curve was 0.6841 0.7841 CI was 0.5941 0.7841. The consistent rate of diagnosis between FAI and HMOA-IR was 71.220.999p / 139mr 蠂 ~ (2) and the result of McNemar 蠂 ~ (2) test showed that the diagnostic accuracy of HMOA-IR was 0.59410.7841%, and the diagnostic accuracy of HMOA-IR was 0.59410.7841.The diagnostic performance of PCOS patients was 72.04%, and the specificity was 65.22% (CI = 0.59410.7841 CI). There was no significant difference between FAI and HOMA-IR (蠂 ~ 2 / 1. 6 P = 0.268). Conclusion there is a positive correlation between FAI and IR in patients with FAI.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R711.75

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 林秀峰;吳日然;杜靜;廖月嬋;杜彥;葉云;姚英姿;吳嘉齊;張旭賓;;游離睪酮指數(shù)對(duì)診斷多囊卵巢綜合征高雄激素血癥不孕患者的價(jià)值[J];中山大學(xué)學(xué)報(bào)(醫(yī)學(xué)科學(xué)版);2010年03期

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本文編號(hào)：1832041