伴多囊卵巢综合征的痤疮性激素水平变化及相关分析

为探讨成年女性痤疮患者血清性激素水平的变化及与多囊卵巢综合征（PCOS）的相关性，对60例成年女性痤疮患者进行血清性激素水平测定和妇科B超检查，其中24例伴PCOS痤疮患者行腹腔镜下微波治疗。结果发现患者组血清睾酮（T），黄体生成素（LH）高于对照组（P＜0．05），微波术后其T，LH值明显下降（P＜0．05），该手术对痤疮治愈率和总有效率分别为58．3％和91．7％，提示成年女性痊痤疮与PCOS有相关性，高雄激素血症可能是引起女性痤疮的主要因素之一。     

青春期后女性痤疮患者血清性激素水平的研究

目的：检测青春期后女性痤疮患者体内性激素的水平。方法：采用放射免疫法对25岁以上的34例女性痤疮患者血清睾酮（T）、雌二醇（E2）、泌尿素（PRL）、黄体生成素（LH）和卵泡刺激素（FSH）进行了测定,并以32例正常女性作为对照。结果：患者组T显著高于对照组（P＜0．001）;E2和LH显著低于对照组（P＜0．001）;PRL和FSH无明显变化（P＞0．05）。结论：性激素异常可能是女性痤疮迟发和持久不退的主要原因。     

青春期痤疮患者血清六项性激素水平的测定

目的探讨青春期寻常型痤疮患者体内性激素水平的改变.方法采用电化学发光免疫分析法对30例青春期女性痤疮患者及18例青春期男性痤疮患者血清六项性激素水平进行检测,并以相应年龄段的15例正常女性及12例正常男性作对照.结果女性青春期痤疮患者血清雌二醇水平明显低于正常对照组(P＜0.05);睾酮/雌二醇比值明显高于正常对照组(P＜0.01);促卵泡素明显高于正常对照组(P＜0.05);男性青春期痤疮患者血清睾酮、雌二醇、孕酮、促卵泡素、黄体生成素、催乳素及睾酮/雌二醇与对照组相比均无显著性差异(P＞0.05).结论青春期女性痤疮患者发病的主要原因可能是由于雌激素分泌不足,使血清内睾酮水平相对增多所致.男性青春期痤疮患者的发病可能与血清六项性激素水平变化无直接关系.     

女性寻常痤疮患者甲状腺激素与性激素的测定及其相互关系的研究

目的：了解女性痤疮患者甲状腺功能的状况及性激素与甲状腺激素的关系。方法：采用放射免疫分析方法,对54例女性座疮患者和30例正常对照者血清中甲状腺激素及8项性激素进行测定。结果：所有痤疮患者及正常对照者血清T3、T4、TSH水平均在所用试剂盒所列正常范围内。但通过患者组与对照组比较发现,患者组T4水平高于正常对照组,差异有高度显著性（P＜0．01）,而T3及TSH无明显变化;相关分析结果表明,T4与各项性激素间均无明显相关（P＞0．05）。结论：与正常对照组相比,女性痤疮患者血清T4水平存在有整体差别;在痤疮的发病中,甲状腺激素可能是在毛囊水平发挥作用。     

女性迟发性痤疮血清性激素及皮质醇水平的研究

目的：探讨女性迟发性痤疮患者体内性激素和皮质醇水平的改变与临床的关系。方法：采用放射免疫分析法，对31例女性迟发性痤疮患者黄体期血清中6种性激素及皮质醇水平进行了测定，并以37例女性青春期痤疮，不同年龄组的46例正常女性作为对照观察。结果：研究组孕酮显著高于青春期痤疮组(P＜0．05)；雄激素、睾酮显著高于正常对照组(P＜0．01)；而皮质醇水平较正常人对照组明显升高(P＜0．05)。结论：女性迟发性痤疮的发生及加重可能与雄激素升高及皮质醇水平异常有关。     

女性痤疮与性激素关系分析

目的：分析女性寻常型痤疮与体内性激素水平的关系.方法：采用放射免疫法对38例女性寻常型痤疮患者进行了6项性激素水平测定,并以36名正常女性作为对照.结果：病例组的血清睾酮（T）水平明显高于对照组（P〈0.01）.结论：女性痤疮的发生与雄激素水平升高或相对升高有密切关系.     

痤疮患者血浆雄激素水平及白细胞雄激素受体的测定

为探讨痤疮患者外周血雄激素及白细胞雄激素受体（AR）含量对痤疮发生发展的影响，对35例痤疮患者和35名正常对照采用放射配体结合分析法测定白细胞雄激素受体含量，同时用放射免疫法检测血浆雄激素水平，结果：男性痤疮患者，血浆睾酮仅轻度升高，但其外周血白细胞AR的水平与对照组相比有明显升高（P＜0．05），女性痤疮患者，血浆睾酮水平及外周血白细胞AR水平与对照组相比均明显升高（P＜0．01），雄激素及其受体含量增高在女性痤疮的发病中可能起着重要的作用，痤疮的严重程度与睾酮水平及白细胞AR水平密切相关。     

皮脂腺及皮下脂肪疾病

20 0 3 1 0 0 8　伴多囊卵巢综合征的痤疮性激素水平变化及相关分析 /罗静英 (广州市皮防所 )…∥临床皮肤科杂志 . 2 0 0 2 ,3 1 (5 ) . 2 77～ 2 78分别对 60例成年女性痤疮患者进行血清性激素水平测定及妇科B超检查 ,3 0例妇科检查正常且无痤疮表现者为对照。结果 :60例痤疮组中有3 8例 (63 .0 0 % )、3 0例对照组中有 2例 (6.66% )妇科B超显示有多囊卵巢图像 ,两组P <0 .0 0 5 ;血清性激素水平痤疮组睾酮 (T )、黄体生成素(LH)值高于对照 ,卵泡刺激素 (LSH )低于对照 ,雌二醇 (E2 )、孕酮 (P)无变化。 2 4例伴多囊卵巢综合征的痤疮…     

女性痤疮血清性激素及胰岛素样生长因子-1的研究

目的：探讨性激素和生长激素在痤疮发病中的作用。方法：采用放射免疫法检测了３０例女性痤疮患者血清睾酮（Ｔ）游离睾酮（ＦＴ）、二氢睾酮（ＤＨＴ）、脱氢表雄酮（ＤＨＥＡ）、雌二醇（Ｅ２）、孕酮（Ｐｒ）、泌乳素（ＰＲＬ）和胰岛素样生长因子－１（ＩＧＦ－１）水平。结果：女性痤疮患者血清ＤＨＴ、ＤＨＥＡ、ＩＧＦ－１明显高于正常对照（Ｐ〈０．０５）,其余指标无显著差异;轻、中、重型痤疮的激素水平无显著差异;ＩＧＦ－１与性激素水平无显著相关（Ｐ〉０．０５）。结论：性激素尤其雄激素和生长激素在痤疮的发病中起了一定的作用。     

524例青春期后女性痤疮患者的性激素和血脂分析

目的：检测青春期后女性痤疮患者血脂和性激素水平变化情况,探讨痤疮与性激素和血脂的关系。方法：收集青春期后女性寻常痤疮患者和健康对照者,检测BMI、甘油三酯、高密度脂蛋白、垂体泌乳素、促卵泡生成素、促黄体生成素、睾酮和硫酸脱氢表雄酮水平和盆腔超声。结果：共纳入524例青春期后女性痤疮患者（轻、中、重度痤疮分别为239例,207例和78例）及50名健康对照。轻、中、重度患者垂体泌乳素、雄烯二酮和硫酸脱氢表雄酮均显著高于健康对照者（P<0.05）。379例患者无多囊卵巢综合征（PCOS）,其中高雄烯二酮患者62例,雄烯二酮水平正常者317例。较雄烯二酮正常组,高雄烯二酮组垂体泌乳素、促黄体生成素、睾酮、硫酸脱氢表雄酮及高密度脂蛋白水平升高,甘油三酯水平降低（均P<0.05）。结论：青春期后女性痤疮患者易合并多种性激素异常,其中雄激素水平升高明显。     

Hormonal Profiles and Prevalence of Polycystic Ovary Syndrome in Women with Acne

One of the important etiologic factors in acne is an increase in sebaceous gland activity, which is androgen dependent. Acne is a common manifestation of hyperandrogenemia. Therefore, acne may not only cause cosmetic concern but may also be a sign of underlying disease. In females, the most common cause of hyperandrogenemia is polycystic ovary syndrome (PCOS). The purpose of this study was to determine the hormonal profiles of women with acne and the prevalence of PCOS in women attending the dermatological clinic with acne problems. The diagnostic criteria of PCOS were clinical findings of menstrual disturbances and hyperandrogenism (acne, seborrhea, hirsutism), pelvic ultrasound imaging of PCO (multiple subcapsular ovarian cysts 2–8 mm. in diameter, with dense echogenic stroma), and an elevated luteinizing hormone (LH) to follicle stimulating hormone (FSH) ratio. There were 51 women with acne; 20 regularly menstruating volunteers without acne served as a control group. PCOS was found in 19 out of 51 patients with acne (37.3%) and none of the control group. Twenty acne patients had abnormal menstruation (39.2%). Acne cases had higher mean levels of serum total testosterone (T), free T, dehydroepiandrosterone sulfate (DHEAS) and prolactin (PRL). No statistically significant difference was observed for LH, FSH or sex hormone binding globulin (SHBG). Because of this high prevalence of PCOS in women with acne, all women presenting with acne should be asked about their menstrual pattern and examined for other signs of hyperandrogenemia. Hormonal profile determination as well as pelvic ultrasonography for ovarian visualization should be performed to confirm the diagnosis of PCOS in female acne patients who have menstrual disturbances.     

Skin improvement with two different oestroprogestins in patients affected by acne and polycystic ovary syndrome: clinical and instrumental evaluation

Background Despite it is accepted that acne is mostly caused by an hyper‐responsiveness of the pilo‐sebaceous unit to normal circulating androgen hormones, in a few patients, especially women, acneic lesions can be associated with increased serum androgen levels (hyperandrogenism), of which polycystic ovary syndrome (PCOS) is the most common cause. In women with acne and proven PCOS therapy with estroprogestins (EPs) can be an excellent option. Objective The aim of the study was to assess the effects of two estroprogestins (EPs), ethinyl‐estradiol (EE) 30 mcg/drospirenone (DRSP) 3 mg, and ethinyl‐estradiol (EE) 30 mcg/chlormadinone acetate (CMA) 2 mg, both on increased serum androgen levels and on several skin parameters in women affected by mild to severe acne and polycystic ovary syndrome (PCOS). Methods Fifty‐nine women were randomized to receive EE/DRSP (n = 32) or EE/CMA (n = 27) for six months. Evaluation of serum androgen levels, grading of acne and hirsutism (respectively with Pillsbury and Ferriman‐Gallwey score) and non‐invasive assessment of skin hydration, transepidermal water loss (TEWL) and skin homogeneity were performed at baseline, at 3 and 6 months (end of treatment). Results Both treatments were well tolerated and showed a significant improvement of skin and hormonal parameters, although EE/DRSP showed a more potent effect on acne and seborrhea. Conclusions Estroprogestins represent an effective and safe treatment in women with acne and polycystic ovary syndrome (PCOS). Nevertheless, the combination EE 30 mcg/DRSP 3 mg appears to be a more potent therapeutic option.     

Ovarian morphology and prevalence of polycystic ovary syndrome in reproductive aged women with or without mild acne

Background Acne and hirsutism are common manifestations of hyperandrogenemia. They may also be a sign of underlying severe diseases. Aim To compare ovarian morphology and prevalence of polycystic ovary syndrome (PCOS) in reproductive aged women with or without mild acne and hirsutism. Methods 52 women with mild acne and 59 age‐matched controls were included in this study. Main outcome measures were the prevalence of PCOS, ovarian morphology, and ovarian stromal thickness in both groups, and acne and hirsutism subgroups. Patients in both groups were taking no hormonal therapy at that time. Androgen profiles were compared between the two groups. Results The prevalence of PCOS was 17.1% (19/111) in all women included in this study. In the acne group, the prevalence of PCOS was 26.9% (14/52), and significantly more prevalent than in control group [8.4% (5/59), P = 0.001]. Total ovarian volume was significantly larger and stromal thickness of the ovary was thicker in women with acne than women without acne. There were no statistically significant difference between the two groups in terms of dehydroepiandrosterone sulfate, and 17‐hydroxyprogesterone, respectively, while serum total testosterone levels were significantly higher (P < 0.05) in women with acne than those women in the control group. Conclusions Acne and hirsutism may not only cause cosmetic concern but may also be a sign of underlying PCOS. Therefore, women presenting with acne and/or hirsutism should be evaluated in terms of PCOS.     

Correlation between endocrinological parameters and acne severity in adult women

Many studies demonstrate increased androgen levels and high prevalence of polycystic ovaries in women affected by acne. We evaluated the relationship between clinical features, ultrasonographic data on polycystic ovaries and hormonal parameters in 129 women >17 years of age with acne. Serum levels of androgens of ovarian and adrenal origin were measured. Menstrual cycle regularity, hirsutism, body mass index and ultrasonographic evaluation of ovaries were recorded. Raised levels of at least one androgen were evident in a majority of our patients. Only 19% of them had polycystic ovary syndrome. Hirsutism and acne severity correlated negatively with serum sex hormone-binding globulin (SHBG) levels (p<0.05). No correlation between acne severity and hirsutism was found. In post-pubertal women, severity of acne seems to depend on peripheral hyperandrogenism, with a negative relationship between the acne severity and serum SHBG levels. We strongly recommend the evaluation of serum SHBG levels in women with acne in order to select patients who can have a better response to appropriate hormonal regimes.     

血清ES、VEGF水平和多囊卵巢综合征患者血清胰岛素及卵巢间质血流的相关性分析

目的探讨分析血清内皮抑素(endostatin,ES)、血管内皮生长因子(vascular endothelial growth factor,VEGF)水平和多囊卵巢综合征(polycystic ovarian syndrome,PCOS)患者血清胰岛素及卵巢间质血流的相关性。方法选取2016年8月至2018年3月滕州市妇幼保健院诊治的85例PCOS患者作为研究对象。将这85例患者设为PCOS组,选择同期在滕州市妇幼保健院健康体检的60例健康女性作为对照组,检测两组受试者血清胰岛素水平、性激素水平、ES以及VEGF水平,并采用经阴道多普勒超声监测受试者卵巢间质血流,记录受试者搏动指数(pulse index,PI)以及阻力指数(resistance index,RI),分析ES以及VEGF水平与各指标相关性。结果 PCOS组患者黄体生成素(luteinizing hormone,LH)、睾酮(testosterone,T)水平显著高于对照组,差异具有统计学意义(P<0.05),两组雌二醇(estradiol,E2)、促卵泡刺激素(follicle stimulating hormone,FSH)以及泌乳素(prolactin,PRL)水平比较差异无统计学意义(P>0.05)。PCOS组患者PI、RI显著低于对照组,差异具有统计学意义(P<0.05),而PCOS组患者胰岛素(insulin,Ins)、VEGF以及ES水平显著高于对照组,差异具有统计学意义(P<0.05)。PCOS患者血清VEGF水平与PI、RI呈显著负相关关系,差异具有统计学意义(P<0.05),与Ins呈显著正相关关系,差异具有统计学意义(P<0.05);患者ES水平与PI、RI呈显著负相关关系,差异具有统计学意义(P<0.05),与Ins呈显著正相关关系,差异具有统计学意义(P<0.05)。结论 PCOS患者血清VEGF以及ES水平显著升高,二者表达与卵巢间质血流增加以及胰岛素水平增加密切相关,可能影响PCOS疾病发展过程。     

The hormonal profile of women with acne and polycystic ovaries

Most women with acne are found to have polycystic ovaries on high resolution pelvic ultrasonography, but most of these women do not manifest the other classical clinical characteristics of the polycystic ovary syndrome. We have compared the endocrinological profile of women with acne who were found to have polycystic ovaries with that of women with polycystic ovaries who presented to an endocrine clinic with hirsutes or non-dermatological manifestations of the polycystic-ovary syndrome. The group of women with acne had normal serum hormonal concentrations. Unlike other women with polycystic ovaries, they did not have significantly elevated serum concentrations of luteinizing hormone or testosterone. By clinical and endocrinological criteria, patients with acne who have polycystic ovaries appear to be a distinct sub-population of women with polycystic ovaries.     

Androgen status in women with late onset or persistent acne vulgaris

The androgen status of fifty women with persistent or late onset acne vulgaris has been investigated. Abnormalities of serum androgens and sex hormone binding globulin (SHBG) alone or in combination were present in 52% of the patients. Elevated serum testosterone and low SHBG were the commonest abnormalities found (46%). Raised levels of serum dehydroepiandrosterone (DHA) and DHA sulphate were present in 16% and 12% of patients respectively, but elevation of one or other of these androgens was the sole abnormality in only 6% of patients. Serum prolactin was raised in 18% of patients but there was no correlation between prolactin and androgen levels. There was also no correlation between the androgen levels and the severity, distribution or pattern of acne or the presence of hirsuties or irregular periods. The hormonal abnormalities found in this group of patients with acne are similar to those seen in females with the polycystic ovary syndrome and idiopathic hirsuties.     

多囊卵巢综合征皮肤表现与生物学指标的相关性研究

目的：评价多囊卵巢综合征(PCOS)患者皮肤表现与血清总睾酮（TT）、游离睾酮指数（FAI）等生化指标的相关性。方法：检测45例PCOS和42例正常对照者的TT、FAI等激素水平。应用改良M-FG标准、痤疮评分系统和Ludwig方案对患者多毛症、痤疮和雄激素性脱发的严重程度进行评分和分级。结果： FAI对多毛症、痤疮和雄激素性脱发的敏感度和特异度分别为80.2%,68.9%,60.3%和41.5%,49.2%,36.8%,明显高于TT的20.6%,21.4%,29.8%和46.5%,44.8%,58.3%。结论：多毛症、痤疮和雄激素性脱发与FAI异常紧密相关,而与TT相关性较低,因此FAI可作为筛查高雄激素血症的重要指标。