多囊卵巢综合征患者月经异常的特点与青春期月经状况的诊断意义

发布时间：2018-03-14 12:00

本文选题：多囊卵巢综合征　切入点：月经模式　出处：《北京协和医学院》2014年博士论文　论文类型：学位论文

【摘要】：目的了解和总结中国多囊卵巢综合征患者的月经表现,探索性研究出生体重、青春期月经情况对于疾病日后诊断的预测意义。方法总结2014年2月至2014年5月在北京协和医院妇产科妇科内分泌门诊就诊,确诊为多囊卵巢综合征的患者236例。对照组为同龄健康女性60例。记录各自的一般信息、尽可能详尽的月经信息(初潮年龄、规律与否、初潮正常后异常发生年龄、改变方式及相关事件、相关评分)、出生体重、家族史等,分析病例组月经改变模式,数值资料组间比较均值差异,探索出生体重、青春期各阶段月经信息等生命早期事件及家族史信息,在预测成年后PCOS诊断上是否具有统计学意义。结果多囊卵巢综合征是一种全身性神经内分泌网络慢性紊乱的症候群,以性激素轴紊乱为主,临床月经表现具有典型的异质性,排卵障碍表现除了经典的初潮起始异常,还有初潮正常后异常和始终正常,月经模式上以月经稀发为主,占86.0%,其他模式亦可单独或组合出现。初始正常后异常的患者在分型上的构成比,与初潮起始异常没有显著区别。初始正常后异常的PCOS患者中有69.7%反馈存在与月经改变相关的事件,年龄上存在16-18岁与28岁两高峰,相关因素包括社会生活因素、肥胖、生活方式、药物等。出生体重对预测日后PCOS诊断没有意义。初潮后2、3年月经异常,及16、17、18岁月经异常的因素均提示日后PCOS的诊断,且初潮后3年、17岁、18岁月经异常,较初潮后2年对PCOS日后诊断有更好的预测意义。17岁月经异常和初潮后3年异常,较16岁可能对PCOS日后诊断有更好的预测意义。糖尿病家族史是PCOS发生的危险因素。结论多囊卵巢综合征是一个典型的异质性综合征,月经表现可以是初潮起始异常、初潮正常后异常和始终正常。初潮正常后异常的PCOS患者在PCOS分型上的构成比,与典型初潮起始异常者没有显著区别。初潮正常后异常的PCOS患者月经改变年龄上存在两个高峰,部分与社会生活因素、肥胖、生活方式、药物等相关。出生体重,对于日后PCOS的诊断预测都没有统计学意义。初潮后3年月经异常,较初潮后2年对PCOS日后诊断有更好的预测意义。17岁、18岁月经异常,较初潮后2年对PCOS日后诊断有更好的预测意义。糖尿病家族史是PCOS发生的危险因素。
[Abstract]:Objective to investigate and summarize the menstrual manifestations of patients with polycystic ovary syndrome (PCOS) in China and to explore the predictive significance of birth weight and puberty menstruation in the diagnosis of PCOS. Methods from February 2014 to May 2014, 236 patients with polycystic ovary syndrome (PCOS) were diagnosed in gynecology and gynecological endocrine clinic of Peking Union Hospital. 60 healthy women of the same age were treated as control group. Their general information was recorded. As detailed as possible menstrual information (age of menarche, regularity or not, age of abnormal occurrence after menarche, mode of change and related events, correlation score, birth weight, family history, etc.). The difference of mean value was compared among the numerical data groups to explore the early life events and family history information such as birth weight and menstrual information of puberty. It was statistically significant to predict the diagnosis of PCOS in adulthood. Results polycystic ovary syndrome (PCOS) is a chronic disorder of systemic neuroendocrine network. The main disorder is sex hormone axis disorder. The clinical menstruation is characterized by typical heterogeneity, and ovulation disorder is characterized by abnormal onset of menarche. There is also abnormal menarche after menarche and always normal. Menstrual pattern is mainly menorrhagia, accounting for 86.0%. Other models can also appear alone or in combination. There was no significant difference between the onset abnormality of menarche and the onset of menarche. There were 69.7% feedback events associated with menstrual changes in PCOS patients with abnormal onset of menarche, and two peaks in age between 16 and 18 years old and 28 years old. The related factors included social life factors, obesity, and obesity. Life style, medicine, etc. Birth weight had no significance in predicting the diagnosis of PCOS in the future. The factors of abnormal menstruation in 2, 3 years after menarche, and abnormal menstruation in 16 ~ 17 years old 18 years old all indicated the diagnosis of PCOS in the future, and the menstrual abnormality of 17 years old or 18 years after menarche, 3 years after menarche. Two years after menarche had a better predictive significance for the diagnosis of PCOS. The abnormal menstruation at 17 and 3 years after menarche might be a better predictor for the diagnosis of PCOS at the age of 16. The family history of diabetes is a risk factor for the occurrence of PCOS. Conclusion Polycystic ovary syndrome is a typical heterogeneity syndrome. Menstrual manifestations can be abnormal after menarche, abnormal after menarche and always normal. The composition ratio of PCOS typing in PCOS patients with normal menarche is significant. There were two peaks in menstrual change age in PCOS patients with abnormal menarche after menarche. Some of them were related to social life factors, obesity, lifestyle, drugs, birth weight, etc. There was no statistical significance in the diagnosis and prediction of PCOS in the future. The abnormal menstruation in 3 years after menarche was better than that in 2 years after menarche. 2 years after menarche is a better predictor for the diagnosis of PCOS. The family history of diabetes is a risk factor for the occurrence of PCOS.
【学位授予单位】：北京协和医学院
【学位级别】：博士
【学位授予年份】：2014
【分类号】：R711.75

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