摘要
目的探讨不同亚型多囊卵巢综合征(PCOS)患者临床、内分泌代谢、糖代谢等相关指标特征,以指导临床个体化的治疗。方法回顾性选取2015~2016年间就诊于首都医科大学附属友谊医院妇科的186例PCOS患者,测定体质量指数、性激素、空腹血糖、血清胰岛素及B超等,依据NIH指南推荐将其四型分为4组:A组[O+HA+P:无排卵或稀发排卵(O),雄激素水平升高的临床和/或生化表现(HA),卵巢多囊样改变(P)];B组[O+HA];C组[O+P];D组[HA+P],另选47例同期就诊的基础体温双相的输卵管或子宫因素导致不孕症患者为对照组,分别评估临床及激素代谢指标。结果 186例PCOS患者,4个亚型的构成比分别为:A组25.3%,B组22.6%,C组46.2%,D组5.9%,其中有高雄激素表现或高雄激素血症的发生率为53.8%。观察组的BMI、INS、HOMA-IR、TG、LDL-C、TSH、E2、T、DHEAS、LH、LH/FSH均高于对照组,A组的TC、TG、LDL-C水平均高于其他各组,且与对照组差异有统计学意义(P<0.05),说明A组引起的脂代谢紊乱最为严重;D组的INS、HOMA-IR水平最高,说明其最容易引起糖代谢紊乱,同时D组的E2、T、DHEA-S水平也显著高于其他各组,说明其代谢特点更值得关注。生化指标HDL-C、FT3、FT4、PRL、FSH在各组间差异均无统计学意义(P>0.05)。结论不同亚型的PCOS患者糖脂代谢及内分泌代谢异常的严重程度不同,了解其代谢特点,有助于采取针对性的个体化治疗,从而达到最理想的治疗效果。
ObjectiveTo discuss metabolic characteristics of different subtypes of polycystic ovarian syndrome(PCOS)in patients with clinical,endocrine metabolism,sugar metabolism related indexes such as features,to guide clinical individual treatment.MethodsFrom2015to2016,186patients with polycystic ovarian syndrome were selected.The body mass index(BMI),sex hormones,fasting blood glucose,serum insulin and B-ultrasonic were detected,and according to the NIH guidelines recommend four types were divided into4groups:Group A[O+HA+P:no ovulation or oligo-ovulation(OO),hyperandrogenism(HA),and polycystic ovary(P)];Group B[O+HA];Group C[O+P];Group D[HA+P],47infertility patients with the same clinic of the basal body temperature bipolar oviduct or uterus factors were selected as control group,respectively.The clinical indicators and hormone metabolism were assessed.ResultsIn186patients,the prevalence of four subtypes were25.3%in group A and group B22.6%,46.2%in group C,group D5.9%,and the incidence of kaohsiung high performance or blood testosterone concentration was53.8%.BMI,INS,HOMA-IR,TG,LDL-C,TSH,LH,E2,T,and DHEA-S,LH/FSH in Observation group were higher than those of the control group,TC,TG,LDL-C level in group A were higher than those in other groups,and compared with the control group,there was statistically significant difference(P<0.05),suggesting lipid metabolic disorder in Group A was the most serious;INS,HOMA-IR in Group D were highest,showing the most likely to lead to glucose metabolic disorder,and E2,T,DHEA-S level in group D were also significantly higher than those of other groups,illustrating its metabolic features more worthy of attention.The difference of HDL-C,FT3,FT4,PRL,FSH between each group were not statistically significant(P>0.05).ConclusionBased on the diagnostic criteria of Rotterdam,PCOS classification method can reflect the type of sugar lipid metabolism and the severity of endocrine metabolic abnormalities.It can help to make individualized treatment and achieve most ideal treatment effect.
作者
肖漪
陈瑛
XIAO Yi;CHEN Ying(Department of Obstetrics and Gynecology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.)
出处
《临床和实验医学杂志》
2017年第23期2364-2367,共4页
Journal of Clinical and Experimental Medicine
关键词
多囊卵巢综合征
鹿特丹标准
分型
代谢特点
Polycystic ovarian syndrome
Rotterdam criteria
Phenotype
The metabolic characteristics
