摘要
摘要目的对女性多囊卵巢综合征的临床特征进行探讨,找到加重PCOS患者代谢紊乱及远期并发症风险的相关因素,从而尽早做出干预,改善PCOS患者的代谢紊乱.方法根据PCOS的诊断标准,制定调查内容,绘制调查表.并由专人对484例PCOS患者进行问卷式调查,对其的代谢特点、临床表现进行分析.结果1.PCOS患者的临床表现呈现多样性.2.484例PCOS患者中A经典型(OA+HA+PCO)26.03%(126/484)、B非PCO型(OA+HA)3.93%(19/484)、C排卵型(HA+PCO)1.86%(9/484)、D非高雄型(OA+PCO)68.18%(330/484).3.PCOS高雄型血清LH、T、DHEAS、LH/FSH、卵巢总体积、LDL高于非高雄型,差异有统计学意义(P<0.05).4.PCOS肥胖型的血清FSH、LH、LH/FSH、HDL值明显低于非肥胖型,差异有统计学意义(P<0.05);PCOS肥胖型的FINS、HOMA-IR、TG、LDL明显高于非肥胖型,差异有统计学意义(P<0.05);PCOS肥胖型IR的发生率明显高于非肥胖型,差异有统计学意义(P<0.05).5.PCOS胰岛素抵抗型血清LH、FSH、LH/FSH、HDL值明显小于非胰岛素抵抗型,差异有统计学意义(P<0.05);PCOS胰岛素抵抗型FINS、BMI、TG、LDL明显高于非胰岛素抵抗型,差异有统计学意义(P<0.05);胰岛素抵抗型肥胖的发生率明显高于非胰岛素抵抗型,差异有统计学意义(P<0.05).6.T与LH、DHEAS、HOMA-IR、LDL、卵巢总体积呈正相关、DHEAS与T、LH/FSH值呈正相关、DHEAS与BMI呈负相关、BMI与FINS、HOMA-IR、TG、LDL呈正相关、BMI与HDL、LH、DHEAS水平呈负相关、FINS与HOMA-IR、BMI、TG、LDL呈正相关、FINS与HDL、LH呈负相关,各个相关系数均具有统计学意义(P<0.05).结论PCOS患者分型分析发现雄激素过多、肥胖、胰岛素抵抗加重PCOS患者脂代谢的异常,应尽早采取干预措施.关键词多囊卵巢综合征;胰岛素抵抗;雄激素;肥胖AbstractObjectivetoexploretheclinicalfeaturesofwomenwithpolycysticovarysyndrome,metabolicdisordersandfindworsenPCOSpatientsaftertheriskfactorsassociatedwithcomplications,thusmakinginterventionassoonaspossible,improvethemetabolicdisorderofPCOSpatients.MethodsaccordingtothePCOSdiagnosticcriteGria,makesurveycontent,drawthequestionnaire.Andbythepeopleoftypesurveywasconductedin484patientswithPCOS,analyzesitsmetaboliccharacteristics,clinicalmanifestation.Results1.TheclinicalmanifestationsofthepatientswithPCOSpresentdiversity.2.Atypicalin484patientswithPCOS(OA+HA+PCO)26.03%(126/484),andhepatitisBthePCO(OA+HA)3.93%(19/484),typeCovulation(HA+PCO)1.86%(9/484),Dtypeofkaohsiung(OA+PCO)68.18%(330/484).3.TypePCOSkaohsiungserumLH,T,DHEAS,LH/FSH,ovarianvolume,LDLwashigherthannonkaohsiung,thedifferencewasstatisticallysignificant(P<0.05).4.PCOSfuelingtheserumFSH,LH,LH/FSH,HDLvaluessignificantlylowerthanfueling,thedifferencewasstatisticallysignificant(P<0.05);PCOSfuelingtheFINS,HOMAIR,TG,LDLwassignificantlyhigherthanfueling,thedifferencewasstatisticallysignificant(P<0.05);TheincidenceofPCOSfuelingIRwassignificantlyhigherthanfueling,thedifferencewasstatisticallysignificant(P<0.05).5.PCOSinsulinresistance,serumLH,FSH,LH/FSH,HDLvalueobviouslysmallerthanthatofnoninsulinresistance,thedifferencewasstatisticallysignificant(P<0.05);PCOSinsulinresistance,FINS,BMI,TG,LDLsignificantlyhigherthanthatofnoninsulinresistance,thedifferencewass(tatisticallysignificant(P<0.05);Theincidenceofinsulinresistance,obesitysignificantlyhigherthanthatofnoninsulinresistance,thedifferencewasstatisticallysignificantP<0.05).6.TandLH,DHEAS,HOMA-IR,LDL,ovarianvolumewerepositivelycorrelated,DHEASwaspositivelycorrelatedwithT,LH/FSHvalues,DHEASandnegGativelycorrelatedwithBMI,BMIandFINS,HOMAIR,TG,LDLwerepositivelycorrelated,BMIandnegativelycorrelatedwithHDL,LH,DHEASlevels,FINSwasinerselya(ssociatedwithhoma-ir,BMI,TG,LDLwerepositivelycorrelated,FINSandHDL,andnegativelycorrelatedwithLH,thecorrelationcoefficientwerestatisticallysignificantP<0.05).ConclusionpatientswithPCOSclassificationanalysisfoundthatandrogenexcess,obesity,insulinresistanceincreaselipidmetabolicabnormalities,PCOSpatientsshouldKteaykeweoarrdlsyinterventionmeasures.polycysticovarysyndromeInsulinresistanceandrogenobesity中图分类号R453文献标识码A文章编号1008-6315(2015)12-0254-02
出版日期
2015年12月22日(中国期刊网平台首次上网日期,不代表论文的发表时间)