新疆地区育龄期女性年龄特异性血清抗苗勒管激素参考区间的建立及临床评估体系的构建:一项基于37 886例的横断面研究OA
Establishment of age-specific serum anti-Müllerian hormone reference intervals and construction of a clinical assessment system for women of reproductive age in Xinjiang:a cross-sectional study based on 37 886 cases
目的 建立新疆地区育龄期女性大样本年龄特异性血清抗苗勒管激素(AMH)水平参考区间,构建可直接指导临床决策的五段式分级评估体系,且基于该体系识别具有明确临床指向性的异常亚群.方法 回顾性收集2021年1月至2025年12月于新疆维吾尔自治区人民医院进行AMH水平检测的20～45岁女性的临床数据.经严格临床排除标准筛选,最终纳入37 886名育龄期女性;采用非参数百分位数法,按1岁年龄间隔计算各年龄组AMH水平百分位数(P2.5、P25、P50、P75及P97.5).基于Loess平滑曲线建立年龄特异性参考区间.通过年龄校正法构建五段式临床分级系统,并识别异常AMH水平亚群.结果 研究人群平均年龄(34.01±6.20)岁.经年龄校正后,AMH水平中位数在21岁达峰值(5.29 ng/ml),20～24岁维持在较高水平,此后随年龄增长持续下降,35岁后呈加速下降趋势.建立了 26个单岁年龄点的精细参考区间及基于年龄校正的五段式临床分级快速查询表.基于单岁参考区间识别出两个异常亚群:年轻低AMH亚群(＜35岁且AMH水平＜P2.5百分位数)487例(占同龄人群2.4％),AMH水平中位数0.05 ng/ml;年长高AMH亚群(≥35岁且AMH水平＞P97 5百分位数)431例(占同龄人群2.4％),AMH水平中位数6.97 ng/ml.结论 本研究首次建立新疆地区大样本人群年龄特异性AMH水平参考区间及五段式临床分级评估体系,成功识别出具有明确临床指向性的异常亚群,为该地区女性卵巢储备功能快速评估与异常状态早期识别提供了科学实用的工具.
Objectives:To establish age-specific reference intervals for serum anti-Müllerian hormone(AMH)in a large sample of women of reproductive age in Xinjiang,construct a five-tier grading evaluation system directly applicable for clinical decision-making,and identify abnormal subgroups with clear clinical significance based on this system. Methods:Clinical data were retrospectively collected from women aged 20-45 years old who underwent AMH testing at the People's Hospital of Xinjiang Uygur Autonomous Region between January 2021 and December 2025.Following strict clinical exclusion criteria,37 886 women of reproductive age were included.The non-parametric percentile method was used to calculate the percentiles(P2.5,P25,P50,P75,and P97.5)of AMH levels for each single-year age group.Age-specific reference intervals were established based on Loess smoothing curves.A five-tier clinical grading system was constructed via age-correction,and subgroups with abnormal AMH levels were further identified. Results:The mean age of the study population was(34.01±6.20)years old.After age correction,the median AMH peaked at 21 years old(5.29 ng/ml)and remained at a high level during 20-24 years old,and then declined with age advancing,with an accelerated decline after 35 years old.Detailed reference intervals for 26 single-age points and an age-corrected five-tier clinical grading quick-reference table were established.Based on the single-age reference intervals,two abnormal subgroups were identified:a young low-AMH subgroup(＜35 years old and AMH＜P2.5)comprising 487 cases(2.4％of peers),with a median AMH of 0.05 ng/ml;and an elderly high-AMH subgroup(≥35 years old and AMH＞P97.5)comprising 431 cases(2.4％of peers),with a median AMH of 6.97 ng/ml. Conclusions:This study establishes large-sample,age-specific AMH reference intervals and a five-tier clinical grading system for women in Xinjiang for the first time.It successfully identifies two abnormal subgroups with clear clinical significance.The findings provide a scientific and practical tool for the rapid assessment of ovarian reserve function and early identification of abnormal status among local women.
马洁;郭敏;王文玲;张彩荣;隋霜;韩翠柳;朱开春
新疆维吾尔自治区人民医院妇产科研究室,乌鲁木齐 830000||新疆宫颈癌防治临床医学研究中心,乌鲁木齐 830000新疆维吾尔自治区人民医院妇产科研究室,乌鲁木齐 830000||新疆宫颈癌防治临床医学研究中心,乌鲁木齐 830000新疆维吾尔自治区人民医院妇产科研究室,乌鲁木齐 830000||新疆宫颈癌防治临床医学研究中心,乌鲁木齐 830000新疆维吾尔自治区人民医院妇产科研究室,乌鲁木齐 830000||新疆宫颈癌防治临床医学研究中心,乌鲁木齐 830000新疆维吾尔自治区人民医院产科,乌鲁木齐 830000新疆维吾尔自治区人民医院妇产科研究室,乌鲁木齐 830000||新疆宫颈癌防治临床医学研究中心,乌鲁木齐 830000新疆维吾尔自治区人民医院妇产科研究室,乌鲁木齐 830000||新疆宫颈癌防治临床医学研究中心,乌鲁木齐 830000
医药卫生
抗苗勒管激素参考区间临床分级异常亚群卵巢储备新疆地区
Anti-Müllerian hormoneReference intervalClinical gradingAbnormal subgroupOvarian reserveXinjiang region
《生殖医学杂志》 2026 (8)
1014-1019,6
新疆维吾尔自治区卫生健康委员会委托项目"天山英才"医药卫生高层次人才培养计划(TSYC202301B050)
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