摘要
目的为多囊卵巢综合征(PCOS)的临床诊治提供依据。方法回顾性分析1040例PCOS患者的临床特征及内分泌、血糖、血脂、胰岛素等检查指标。结果①1040例PCOS患者中,月经稀发占62.60%,闭经占19.71%,所有成年患者的月经紊乱史均可追溯到青春期初潮后;450例存在肥胖(259例为腹部型);158例存在黑棘皮症(肥胖型103例,非肥胖型55例)。②PCOS患者中高甘油三酯血症占5.58%、高胆固醇血症占7.02%、HDL异常占0.10%、LDL异常占12.69%,其中肥胖患者胆固醇、低密度脂蛋白明显高于非肥胖患者,P<0.05。173例符合糖尿病诊断标准,179例糖耐量减低(IGT),27例空腹葡萄糖异常(IFG),9例IFG+IGT;平均空腹及口服葡萄糖耐量试验(OGTT)30、60、120和180 min血糖超过正常范围的人次分别为19、74、110、42和12,如果不取空腹血糖值有10例患者被漏诊,分别略去30、60、120和180 min的血糖值,依次有16、50、28和1例被漏诊,5次抽血及3次抽血(空腹+60 min+120 min)的血糖及胰岛素曲线下面积有显著差异;体质量指数(BMI)和腰臀比(WHR)均与胰岛素抵抗指数(HOMA-IR)呈正相关(r=0.29987、P<0.01,r=0.12441、P<0.0001)。结论PCOS患者肥胖发生率较高,肥胖型PCOS患者较非肥胖型存在更严重的内分泌及代谢紊乱;阻断肥胖、IR,打破内分泌代谢间的恶性循环,不但对阻断PCOS的进程具有重要意义,更是预防2型糖尿病、心血管疾病等远期并发症的关键。
Objective To provide basis for the clinical diagnose and treatment of polycystic ovary syndrome （ PCOS）. Methods One thousand and forty PCOS patients attending the clinic of Shandong Provincial Hospital Human Reproductive Center were included in this retrospective study. All the patients had been performed a 75 g OGTT. Clinical presentations, serum hormonal levels, glucose levels, insulin levels and lipid were reviewed. Results The presence of oligomenorrhea was 62. 6% while amenorrhea was 19.71%. Menstrual disorder of all the adult patients could be traced back to their adolescent menarche. There were 450 obesity cases （ of which 259 patients were central obesity）. The incidence of acanthosis nigricans was 15.19%, 65.19% with obesity. Cholesterol （4. 8 ± 0. 98 vs 4. 61 ±0. 86） and LDL （3. 80 ± 6. 92 vs 2. 88 ± 1.01 ） were both significantly higher in the obesity patients than those in the non-obesity patients. 173 patients were diagnosed as diabetes mellitus （DM）, 179 IGT, 27 IFG and 9 IFG and IGT. Those women with plasma glucose values abnormality of 0, 30, 60, 120, 180 min were 19, 74, 110, 42 and 12 cases respectively. Ten patients would have been undetected if fasting plasma glucose levels were not evaluated, while omission of 30, 60, 120, or 180 min plasma glucose levels would have resulted in 16, 50, 28 and 1 case being missed respectively. If took three times blood samples to evaluate plasma glucose levels, 39 （0 min ＋ 30 min ＋ 60 min）, 102 （0 min ＋ 30 rain ＋ 120 min）, 21 （0 min ＋ 30 min ＋ 180 min）, 34（0 min ＋60 min ＋ 120 min）, 45（0 min ＋60 min＋ 180 min） and 123 （0 min ＋ 120 min ＋ 180 min） would be missed. Compared AUC of plasma glucose and insulin in 5 times with 3 times （0 min ＋30 min ＋60 min）, the differences were statistically significant. Body mass index （BMI） was positively correlated with HOMA-IR （ r = 0. 29987, P 〈 0. 01 ） as well as WHR（r = 0. 12441, P 〈 0. 000 1 ）. Conclusions The prevalence rate of o
出处
《山东医药》
CAS
北大核心
2008年第11期4-6,共3页
Shandong Medical Journal
基金
国家自然科学基金资助项目(30670777)
国家863资助项目(2006AA02Z4A4)
关键词
多囊卵巢综合征
胰岛素抵抗
代谢
葡糖耐量试验
polycystic ovary syndrome
insulin resistance
metabolism
glucose tolerance test
