摘要
目的探讨汉族育龄妇女患多囊卵巢综合征(PCOS)的临床特征。方法根据欧洲人类生殖协会(ESHRE)和美国生殖医学协会(ASRM)提出的,将符合稀发排卵、高雄激素征象及卵巢多囊样表现3项中的2项即可诊断PCOS的标准(即ESHRE/ASRM诊断标准),采用分层整群随机抽样的方法,以问卷方式调查了山东省山东大学某地区1027名育龄妇女,对检出的PCOS患者的临床表现、糖代谢特征进行分析;并与同期94名月经正常、已正常生育、无痤疮、无男性毛发分布及无卵巢多囊表现等的妇女(对照组)进行比较。结果(1)1027份调查问卷,收回有效问卷828份(即828名调查对象),问卷反馈率为80·62%。共检出PCOS患者85例,其中≤35岁患者为97·65%(83/85)。(2)同年龄段PCOS患者的月经周期较对照组长,反映临床高雄激素征象及程度的多毛F-G分数、睾酮、游离雄激素指数较对照组高,平均小卵泡数均较对照组多,血清性激素结合球蛋白较对照组降低,以上两者分别比较,差异均有统计学意义(P<0·01)。85例PCOS者的月经稀发程度、F-G分数、痤疮的发生情况、平均小卵泡数,随年龄增长呈现逐渐缩短或降低的趋势。(3)PCOS有不孕史患者的胰岛素抵抗指数为1·49±0·73,无不孕史患者为1·31±0·66,两者比较,差异有统计学意义(t=2·058;P<0·05)。PCOS肥胖患者的空腹胰岛素为(8·50±3·46)mU/L、空腹血糖为(5·70±2·27)mmol/L、胰岛素敏感指数为0·025±0·015;非肥胖患者空腹胰岛素为(5·45±0·54)mU/L、空腹血糖为(4·88±0·45)mmol/L,胰岛素敏感指数为0·044±0·026,以上两者比较,差异均有统计学意义(P<0·01,P<0·05)。结论按照ESHRE/ASRM诊断标准,35岁以下的育龄妇女是PCOS患者的主要群体;PCOS患者的稀发排卵、高雄激素征象、卵巢多囊表现等临床特征随年龄增长而变化;育龄期PCOS合并不孕、肥胖患者存在糖代谢改变,应重视其胰岛素抵抗现象。
Objective To carry out an epidemiological study of clinical characteristics of Chinese Hart ethnic women with polycystic ovary syndrome （PCOS）. Methods According to Revised 2003 European Society for Human Reproduction and Embryology/American Society for Reproductive Medicine criteria, PCOS can be diagnosed with 2 manifestations out of oligo-or anovulation, clinical and/or biochemical signs of hyperandrogenism exclusion of other etiologies and polycystic ovaries. One thousand and twenty-seven women in reproductive age from one area in Jinan city were investigated and the clinical, metabolic characteristics of the PCOS patients were analyzed. Results （ 1 ） A total of 828 questionnaires were collected from 1027 women; the response rate was 80. 62%. Eighty-five PCOS patients were diagnosed; PCOS accounted for 97. 65% （83/85） in ≤ 35 years old population groups; （2） Clinical manifestations were different between PCOS groups and controls in each age stage （P 〈 0. 05 ）; Menstruation, body hair Ferriman-Gallny （F-G） score, ache, ovarian follicle numbers decreased with aging among PCOS groups, and menstruation cycle was longer, testosterone（T）, free androgen index（FAI） and ovarian follicle numbers were higher, sex hormone-binding globulin（SHBG） was lower than control groups of the same age respectively （ P 〈 0. 01 ） ; （ 3 ） Homeostasis model assessment-insulin resistance （Homa-IR） index in infertility PCOS group was higher than in fertility group （1.49 ±0. 73 vs 1.31 ±0. 66; t =2. 058; P 〈 0. 05 ） ; fasting insulin, fasting blood glucose in obesity PCOS group was higher than in non-obesity group （8.50±3.46vs5.7±2.3,t=2.984;P〈0.01, 5.45 ±0.54 vs4.88±0, d5,t=2.891;P〈0.01） , in contrast, insulin sensitivity index was lower in obesity PCOS group than in non-obesity group （0. 025 ± 0. 015 vs 0. 044 ± 0. 026 ; t = 2. 292, P 〈 0. 05 ）. Conclusions （ 1 ） PCOS mainly distributes in ≤ 35 years old population; （2） clinical manifestations of oligo-ovulation, clinical and/or biochemical signs of hyperandrogenism, polycystic ovaries of PCOS change with age increase. （3） PCOS with infertility and obesity is usually associated with glucose metabolic changes, especially insulin resistance.
出处
《中华妇产科杂志》
CAS
CSCD
北大核心
2006年第6期375-379,共5页
Chinese Journal of Obstetrics and Gynecology
关键词
多囊卵巢综合征
流行病学
汉族
Polycystic ovary syndrome
Epidemiology
Han nationality
