不同亚型的多囊卵巢综合征患者临床及实验室指标特征的研究
发布时间：2018-08-03 19:20
【摘要】：目的基于鹿特丹标准,依据美国国立卫生院(National Institutes of Health,NIH)最新指南推荐,探讨不同亚型多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者临床、内分泌代谢等相关指标特征,以指导临床治疗。方法募集2014年12月至2015年5月在首都医科大学附属北京妇产医院内分泌科就诊的PCOS患者647例,测定人体学指标、性激素及血脂、血糖、胰岛素及阴道B超等,依据NIH指南推荐将其四型分为4组:A组409例〔O+HA+P:无排卵或稀发排卵(oligo-ovulation,O),雄激素水平升高的临床和(或)生化表现(hyperandrogeoism,HA),卵巢多囊样改变(polycystic ovary,P)〕;B组58例(O+HA);C组101例(HA+P);D组79例(O+P),另选同期就诊的基础体温双相的输卵管因素不孕症患者60例为对照组,分别评估临床及激素代谢指标。结果 647例患者,4个亚型的患病率分别为:A组63.2%,B组9%,C组15.6%,D组12.9%,647例患者中有高雄表现或血雄激素浓度高的发生率为87.8%。A组与B组:高雄血症、腰围、胰岛素抵抗及三酰甘油均明显增高,但A组最重,B组次之。C组与A、B两组相比,临床和内分泌代谢特征温和,但与对照组相比,黄体生成素(luteinizing hormone,LH)、黄体生成素/卵泡刺激素(LH/follicle stimulating hormone,FSH)均明显增高(P0.05)。D组与对照组间体质量指数(body mass index,BMI)、腰围、臀围、Ferryman-Gallwey评分结果相似。部分特殊化指标质量浓度各组间差异均无统计学意义(P0.05)。结论 1)基于鹿特丹诊断标准的PCOS分型方法可反映疾病的基本特征。2)高雄激素血症和/或多毛评分是区分PCOS不同亚型最主要的依据,可能是代谢障碍严重程度不同的结果。与标准组(Ⅰ型和Ⅱ型相比),正常排卵组和非高雄组可代表PCOS相对温和的表型。而非高雄组PCOS可能有不同的致病途径。因此对于不同分型PCOS患者的治疗也应该个体化。
[Abstract]:Objective to investigate the clinical, endocrine and metabolic characteristics of patients with different subtypes of polycystic ovary syndrome (polycystic ovary syndromes) according to the Rotterdam standard and the latest guidelines of the National Institutes of Health (NIH), so as to guide the clinical treatment. Methods from December 2014 to May 2015, 647 patients with PCOS were enrolled in the Department of Endocrinology, Beijing Obstetrics and Obstetrics Hospital affiliated to Capital Medical University. The indexes of human body, sex hormone, blood lipid, blood glucose, insulin and vaginal B ultrasound were measured. According to the recommendations of NIH guidelines, the four types were divided into 4 groups: group A: 409 cases of (O HA: anovulation or oligo-ovulationo, hyperandrogeoismHA, polycystic ovaries P); Group B, 58 cases of (O HA); Group C, 101 cases; Group B, 101 cases; Group C, 58 cases; Group B, Group B; Group B; Group B, 58 cases; Group B, Group B; Group B; Group B; Group B; Group B; Group B; Group B; Group B; (HA P) D group (n = 79) and (O P), group (n = 79) were randomly divided into two groups: 60 patients with sterility due to tubal factors with basic body temperature in the same period were selected as control group. The clinical and hormone metabolic indexes were evaluated. Results the prevalence rates of 4 subtypes in 647 patients were as follows: 63.2% in group A and 63.2in group B, respectively. The incidence of hyperandrogenemia and waist circumference in group A and group B were 87.8% and 87.8% respectively, and those in group C, and the incidence of high androgen concentration were 87.8% and 87.8%, respectively. Insulin resistance and triacylglycerol were significantly increased, but the clinical and endocrine metabolic characteristics were mild in group A, group B, and group A. Luteinizing hormone LH, luteinizing hormone / follicle stimulating hormone (LH/follicle stimulating hormonetine FSH) were significantly increased (P0.05). Group D was significantly higher than control group (P 0.05). The score of Ferryman-Gallwey score of waist circumference and hip circumference was similar between group D and control group. There was no significant difference in the mass concentration of some special indexes among groups (P0.05). Conclusion 1) the PCOS typing method based on Rotterdam diagnostic criteria can reflect the basic characteristics of the disease. 2) Hyperandrogenemia and / or hirsutism score are the most important basis for distinguishing different subtypes of PCOS, and may be the result of different severity of metabolic disorders. Compared with the standard group (type 鈪，
本文编号：2162754
[Abstract]:Objective to investigate the clinical, endocrine and metabolic characteristics of patients with different subtypes of polycystic ovary syndrome (polycystic ovary syndromes) according to the Rotterdam standard and the latest guidelines of the National Institutes of Health (NIH), so as to guide the clinical treatment. Methods from December 2014 to May 2015, 647 patients with PCOS were enrolled in the Department of Endocrinology, Beijing Obstetrics and Obstetrics Hospital affiliated to Capital Medical University. The indexes of human body, sex hormone, blood lipid, blood glucose, insulin and vaginal B ultrasound were measured. According to the recommendations of NIH guidelines, the four types were divided into 4 groups: group A: 409 cases of (O HA: anovulation or oligo-ovulationo, hyperandrogeoismHA, polycystic ovaries P); Group B, 58 cases of (O HA); Group C, 101 cases; Group B, 101 cases; Group C, 58 cases; Group B, Group B; Group B; Group B, 58 cases; Group B, Group B; Group B; Group B; Group B; Group B; Group B; Group B; Group B; (HA P) D group (n = 79) and (O P), group (n = 79) were randomly divided into two groups: 60 patients with sterility due to tubal factors with basic body temperature in the same period were selected as control group. The clinical and hormone metabolic indexes were evaluated. Results the prevalence rates of 4 subtypes in 647 patients were as follows: 63.2% in group A and 63.2in group B, respectively. The incidence of hyperandrogenemia and waist circumference in group A and group B were 87.8% and 87.8% respectively, and those in group C, and the incidence of high androgen concentration were 87.8% and 87.8%, respectively. Insulin resistance and triacylglycerol were significantly increased, but the clinical and endocrine metabolic characteristics were mild in group A, group B, and group A. Luteinizing hormone LH, luteinizing hormone / follicle stimulating hormone (LH/follicle stimulating hormonetine FSH) were significantly increased (P0.05). Group D was significantly higher than control group (P 0.05). The score of Ferryman-Gallwey score of waist circumference and hip circumference was similar between group D and control group. There was no significant difference in the mass concentration of some special indexes among groups (P0.05). Conclusion 1) the PCOS typing method based on Rotterdam diagnostic criteria can reflect the basic characteristics of the disease. 2) Hyperandrogenemia and / or hirsutism score are the most important basis for distinguishing different subtypes of PCOS, and may be the result of different severity of metabolic disorders. Compared with the standard group (type 鈪，
本文编号：2162754
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