PCOS患者血清血管生成素样蛋白2、4水平与卵巢间质血流动力学的关系

doi:10.11958/20222119

天津医药 ›› 2023, Vol. 51 ›› Issue (9): 988-992.doi: 10.11958/20222119

PCOS患者血清血管生成素样蛋白2、4水平与卵巢间质血流动力学的关系

赵芳园¹(), 邹红¹, 时思毛², 徐芳², 左冬冬³^,^△()

1.黑龙江中医药大学附属第一医院超声医学科（邮编150040）
2.黑龙江中医药大学附属第一医院妇科（邮编150040）
3.黑龙江中医药大学附属第一医院医院前治疗中心（邮编150040）

收稿日期:2022-12-27 修回日期:2023-03-14 出版日期:2023-09-15 发布日期:2023-09-13
通讯作者: △E-mail：87312569@qq.com
作者简介:赵芳园（1982），女，主治医师，主要从事超声医学诊断方面研究。E-mail：fsa15384@163.com
基金资助:
黑龙江省中医药管理局科研项目(2018-064)

Changes of serum angiopoietin-like protein 2 and 4 levels and their relationship with ovarian interstitial hemodynamics in patients with PCOS

ZHAO Fangyuan¹(), ZOU Hong¹, SHI Simao², XU Fang², ZUO Dongdong³^,^△()

1. Department of Ultrasound Medicine, the First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine, Harbin 150040, China
2. Department of Gynaecology, the First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine, Harbin 150040, China
3. Preventive Medicine Centre, the First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine, Harbin 150040, China

Received:2022-12-27 Revised:2023-03-14 Published:2023-09-15 Online:2023-09-13
Contact: △E-mail：87312569@qq.com

赵芳园, 邹红, 时思毛, 徐芳, 左冬冬. PCOS患者血清血管生成素样蛋白2、4水平与卵巢间质血流动力学的关系[J]. 天津医药, 2023, 51(9): 988-992.

ZHAO Fangyuan, ZOU Hong, SHI Simao, XU Fang, ZUO Dongdong. Changes of serum angiopoietin-like protein 2 and 4 levels and their relationship with ovarian interstitial hemodynamics in patients with PCOS[J]. Tianjin Medical Journal, 2023, 51(9): 988-992.

摘要/Abstract

摘要：

目的探讨多囊卵巢综合征（PCOS）患者血清血管生成素样蛋白2、4（Angptl2、Angptl4）与卵巢间质血流动力学的关系。方法选取123例PCOS患者（PCOS组）及41例健康志愿者（对照组），比较2组血清Angptl2、Angptl4水平及卵巢间质收缩期最大血流速度（PSV）、搏动指数（PI）、阻力指数（RI）；分析Angptl2、Angptl4与PSV、PI、RI及PCOS的关系及两者对PCOS的预测价值。结果 PCOS组左右侧卵巢间质PI、RI均低于对照组，PSV高于对照组（P<0.05）。Pearson分析显示，PCOS患者血清Angptl2、Angptl4与左右侧卵巢间质PSV呈正相关，与PI、RI呈负相关（P<0.01）。Logistic回归结果显示，高HOMA-IR（OR=1.921，95%CI：1.017~4.154）、高BMI（OR=1.459，95%CI：1.085~3.220）、高Angptl2（OR=2.625，95%CI：1.330~6.324）、高Angptl4（OR=3.543，95%CI：1.915~8.147）是影响PCOS发生的危险因素（P<0.05）。受试者工作特征（ROC）曲线显示，血清Angptl2、Angptl4单独应用时，预测PCOS的AUC（95%CI）为0.747（0.661~0.821）、0.769（0.685~0.841），低于两者联合应用的0.879（0.793~0.921，P<0.05）。结论血清Angptl2、Angptl4在PCOS患者中异常升高，与卵巢间质血流动力学相关，且两者与PCOS发生密切相关，可作为评估PCOS的参考指标。

关键词: 多囊卵巢综合征, 卵巢间质, 血流动力学, 血管生成素样蛋白2, 血管生成素样蛋白4

Abstract:

Objective To investigate changes of serum Angptl2 and Angptl4 levels in patients with polycystic ovary syndrome (PCOS) and their relationship with ovarian interstitial hemodynamics. Methods A total of 123 PCOS patients (the PCOS group) and 41 healthy volunteers (the control group) were selected. The serum Angptl2 and Angptl4 levels, the peak systolic velocity (PSV), pulsation index (PI) and resistance index (RI) of ovarian interstitial were compared between the two groups. The relationship between Angptl2, Angptl4, PSV, PI, RI and PCOS and their predictive value to PCOS were analyzed. Results The PI and RI values of left and right ovarian interstitial were lower in the PCOS group than those in the control group, and PSV values were higher than those in the control group (P<0.05). Pearson analysis showed that serum Angptl2 and Angptl4 were positively correlated with PSV of left and right ovarian interstitial, and negatively correlated with PI and RI of left and right ovarian interstitial in patients with PCOS (P<0.01). Logistic regression results showed that high HOMA-IR (OR=1.921, 95%CI: 1.017-4.154), high BMI (OR=1.459, 95%CI: 1.085-3.220), high Angptl2 (OR=2.625, 95%CI: 1.330-6.324), high Angptl4 (OR=3.543, 95%CI: 1.915-8.147) levels were related factors affecting the occurrence of PCOS (P<0.05). Receiver operating characteristic curve (ROC) showed that the AUC (95%CI) of predicted PCOS were 0.747 (0.661-0.821) and 0.769 (0.685-0.841) when serum Angptl2 and Angptl4 were used alone. It was lower than that of 0.879 (0.793-0.921, P<0.05) for the combined application. Conclusion The abnormal levels of serum Angptl2 and Angptl4 in PCOS patients are related to the hemodynamics of ovarian interstitial, and they are closely related to the occurrence of PCOS, which can be used as reference indexes for the evaluation of PCOS.

Key words: polycystic ovary syndrome, ovarian interstitial, hemodynamics, angiopoietin-like protein 2, angiopoietin-like protein 4

中图分类号:

R711.75

图/表 8

参考文献 24

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组别		n	年龄/岁		BMI/（kg/m²）		FSH/（U/L）		LH/（U/L）
对照组		41	31.12±3.16		22.65±3.42		4.23±1.37		5.77±3.01
PCOS组		123	31.30±3.44		26.18±3.20		4.65±1.25		12.40±4.23
t			0.294		6.012^＊＊		1.816		9.287^＊＊
组别	LH/FSH 比值			E₂/（pg/L）		T/ （nmol/L）		PRL/ （nmol/L）		HOMA- IR
对照组	1.35±0.49			46.34±14.50		1.24±0.64		0.72±0.30		2.91±0.50
PCOS组	2.68±0.61			41.90±13.84		3.65±1.26		0.66±0.24		4.25±0.72
t	12.646^＊＊			1.758		11.719^＊＊		1.098		11.051^＊＊

组别		n	年龄/岁		BMI/（kg/m²）		FSH/（U/L）		LH/（U/L）
对照组		41	31.12±3.16		22.65±3.42		4.23±1.37		5.77±3.01
PCOS组		123	31.30±3.44		26.18±3.20		4.65±1.25		12.40±4.23
t			0.294		6.012^＊＊		1.816		9.287^＊＊
组别	LH/FSH 比值			E₂/（pg/L）		T/ （nmol/L）		PRL/ （nmol/L）		HOMA- IR
对照组	1.35±0.49			46.34±14.50		1.24±0.64		0.72±0.30		2.91±0.50
PCOS组	2.68±0.61			41.90±13.84		3.65±1.26		0.66±0.24		4.25±0.72
t	12.646^＊＊			1.758		11.719^＊＊		1.098		11.051^＊＊

组别	n	Angptl2	Angptl4
对照组	41	2.60±0.61	12.81±3.57
PCOS组	123	5.12±0.94	26.11±5.10
t		16.211^＊＊	15.471^＊＊

组别	n	Angptl2	Angptl4
对照组	41	2.60±0.61	12.81±3.57
PCOS组	123	5.12±0.94	26.11±5.10
t		16.211^＊＊	15.471^＊＊

组别	n		PSV/（cm/s）
组别	n		左侧		右侧
对照组	41		6.58±1.03		6.59±1.10
PCOS组	123		9.15±1.25		9.18±1.14
t			11.912^＊＊		12.686^＊＊
组别		PI/%
组别		左侧		右侧
对照组		1.07±0.17		0.94±0.20
PCOS组		0.85±0.16		0.81±0.13
t		7.399^＊＊		4.886^＊＊
组别		RI/%
组别		左侧		右侧
对照组		0.59±0.06		0.58±0.08
PCOS组		0.52±0.08		0.53±0.07
t		4.427^＊＊		3.120^＊＊

PCOS患者血清血管生成素样蛋白2、4水平与卵巢间质血流动力学的关系

Changes of serum angiopoietin-like protein 2 and 4 levels and their relationship with ovarian interstitial hemodynamics in patients with PCOS

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项目	侧别	Angptl2		Angptl4
项目	侧别	r	P	r	P
PSV	左侧	0.415	0.005	0.502	<0.001
	右侧	0.404	0.006	0.333	<0.001
PI	左侧	-0.621	<0.001	-0.489	<0.001
	右侧	-0.619	<0.001	-0.377	<0.001
RI	左侧	-0.650	<0.001	-0.307	0.001
	右侧	-0.642	<0.001	-0.300	0.001

指标	β	SE	Wald χ²	P	OR	OR 95%CI
HOMA-IR	0.653	0.311	4.409	0.035	1.921	1.017~4.154
BMI	0.378	0.090	17.640	<0.001	1.459	1.085~3.220
Angptl2	0.965	0.421	5.254	0.022	2.625	1.330~6.324
Angptl4	1.265	0.345	13.444	<0.001	3.543	1.915~8.147
年龄	0.002	0.003	0.444	0.257	1.002	0.820~1.261
LH/FSH	0.220	0.203	1.175	0.134	1.246	0.754~1.827
LH	0.014	0.012	1.361	0.124	1.104	0.700~1.114
T	0.036	0.030	1.440	0.091	1.307	0.725~1.374
常数项	1.217	1.314	0.859	0.354	3.375

指标	最佳截断值/ （μg/L）	敏感度/%	特异度/%	约登指数	AUC（95%CI）
Angptl2	3.34	74.80	85.37	0.602	0.747（0.661~0.821）
Angptl4	18.82	81.30	73.17	0.545	0.769（0.685~0.841）
联合		75.60	90.24	0.658	0.879（0.793~0.921）

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