抗苗勒管激素在多囊卵巢综合征发病及诊治中的作用

doi:10.12280/gjfckx.20230141

摘要/Abstract

摘要：

多囊卵巢综合征（polycystic ovarian syndrome，PCOS）是一种较常见的女性生殖内分泌代谢紊乱性疾病，病因和发病机制复杂。近年研究发现，抗苗勒管激素（anti-Müllerian hormone，AMH）是影响PCOS病理生理的一个重要因素。AMH与卵泡发育、高雄激素血症、下丘脑-垂体-卵巢轴和遗传密切相关，AMH可以抑制始基卵泡募集和小窦卵泡生长，防止卵巢过早衰竭。AMH与雄激素之间相互作用，还可加重卵泡生长发育障碍。另外，AMH可以激活促性腺激素释放激素（gonadotropin-releasing hormone，GnRH）神经元放电，黄体生成素（luteinizing hormone，LH）分泌增加，进而导致雄激素生成增加。而且，PCOS孕妇高AMH状态可以导致女性后代男性化，成年后出现PCOS样的生殖和神经内分泌表型。同时AMH还可能作为诊断PCOS的新指标，AMH的水平也可以反映和预测PCOS患者的治疗效果。

关键词: 多囊卵巢综合征, 抗苗勒管激素, 排卵, 雄激素增多症, 诊断, 治疗

Abstract:

Polycystic ovary syndrome (PCOS) is a relatively common female reproductive endocrine and metabolic disorder with complex etiology and pathogenesis. Recent studies have found that anti-Müllerian hormone (AMH) is an important factor affecting the pathophysiology of PCOS. AMH is closely related to follicular development, hyperandrogenism, hypothalamic-pituitary-ovarian axis and heredity. AMH can inhibit primordial follicle recruitment and small sinus follicle growth, and prevent premature ovarian failure. AMH also exacerbates follicular growth and development disorders by interacting with androgens. In addition, AMH can activate the discharge of gonadotropin-releasing hormone (GnRH) neurons and increases the secretion of luteinizing hormone (LH), which in turn leads to the increase of androgen production. Moreover, high AMH status in pregnant women with PCOS can lead to masculinization of female offspring and PCOS-like reproductive and neuroendocrine phenotypes in adulthood. At the same time, AMH may also be a new indicator for the diagnosis of PCOS, and the determination of AMH level can also reflect and predict the therapeutic effect of PCOS patients.

Key words: Polycystic ovary syndrome, Anti-mullerian hormone, Ovulation, Hyperandrogenism, Diagnosis, Therapy

高雅, 鲁娣, 宋殿荣. 抗苗勒管激素在多囊卵巢综合征发病及诊治中的作用[J]. 国际妇产科学杂志, 2023, 50(5): 540-544.

GAO Ya, LU Di, SONG Dian-rong. Role of Anti- Müllerian Hormone in Pathogenesis, Diagnosis and Treatment of Polycystic Ovary Syndrome[J]. Journal of International Obstetrics and Gynecology, 2023, 50(5): 540-544.

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