异常月经周期与多囊卵巢综合征的相关性分析

目的分析异常月经周期与多囊卵巢综合征的相关性。方法调查2009年10月-2010年1月期间,在北京妇产医院和北医三院生殖中心的门诊病人810例并采用2003年鹿特丹标准诊断多囊卵巢综合征,分析两者间的关系。结果 1.810名妇女中月经周期异常占68.9%(558/810)。月经稀发和闭经占异常月经周期的99.1%(553/558),月经稀发所占比例最高(65.6%,366/558),月经频发比例最小(0.9%,5/558)。2.随着年龄的增加,月经稀发与闭经的发生率呈逐渐降低的趋势,而正常月经周期所占的比例则逐渐增加(P=0.000)。3.多囊卵巢综合征有523例。在月经稀发患者中多囊卵巢(PCO)占83.3%(305/366);高雄激素血症(HA)占52.7%(193/366)。闭经患者中多囊卵巢占90.4%(169/187);高雄激素血症占61.5%(115/187)。月经稀发和闭经PCOS患者中,均以月经稀发/闭经(O)+多囊卵巢(P)+高雄(H)最多见。O+H亚型与O+P+H比较,O+H主要以月经稀发为主,而O+P+H的闭经率则显著高于经典型O+H。结论月经稀发与PCOS关系密切,可以作为PCOS的第一步筛查指标。要重视月经周期超过35天的妇女。

The relationship of abnormal menstrual cycle and polycystic ovarian syndrom

Objective：To analysis the relationship of abnormal menstrual cycle and polycystic ovary syndrom（PCOS）.Methods：From Oct 2009 to Jan 2010,the PCOS women were identified from 810 outpatients recruited from the Reproductive Medical Centre of Beijing Obstetrics and Gynecology Hospital and the third Hospital of Peking University.The relationship of abnormal cycles with PCOS were analysed.Each woman was interviewed by a questionnaire including age,menarche,menstrual cycle history,related family history,mF-G scoring and so on,and then received transvaginal ultrasound scanning.Fasting blood samples were obtained for extensive endocrine evaluation.Results：1.558 abnormal menstrual cycles were identified from 810 outpatients（68.9%,558 /810）,with 553 oligomenorrhea/amenorrhea（99.1 %,553 /558） of which the most popular type was oligomenorrhea（65.6%,366 /558）.2.With increasing of the age the incidence of oligomenorrhea and amenorrhea gradually decreased（P = 0.000）.3.523 women were diagnosed as PCOS with the 2003 revised Rrotterdam criteria.Of the oligomenorrhea women,the PCO were 83.3%（305 /366） and the clinical hyperandrogenism（HA） were 52.7%（193 /366）.Of the amenorrhea women,the PCO were 90.4%（169 /187） and the clinical hyperandrogenism（HA） were 61.5%（115 /187）.Of both oligomenorrhea PCOS and amenorrhea PCOS,oligo/amenorrhea ＋ PCO ＋ HA（O ＋ P ＋ H） were the most comon phenotype.Of the menstrual cycles oligomenorrhea was more prevalent in the O ＋ H phenotype and amenorrhea in the O ＋ P ＋ H.Conclusion Oligo/amenorrhea were positively correlated with PCOS and might be the first simple indicator for screaning PCOS.