不同糖耐量状态肥胖儿童血清脂联素的变化及其临床意义

目的了解不同葡萄糖耐量状态的肥胖儿童血清脂联素水平，探讨其与年 龄、体重指数(BMI)、血脂、血糖及胰岛素水平的关系。方法选择2002~2004年于广州市儿童医院初诊并住院诊治的肥胖儿童52例，分为36例糖耐量正常(NGT)肥胖组和16例糖耐量受损(IGT)肥胖组。测定两组肥胖儿童和41例年龄、性别匹配的正常儿童空腹血清脂联素、胆固醇(CHO)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL C)、血糖和胰岛素(FINS)，计算胰岛素抵抗指数(HOMA IR)。肥胖组儿童均做口服葡萄糖耐量试验(OGTT)，测定OGTT 2h血糖和胰岛素。结果正常对照组、NGT肥胖组及IGT肥胖组血清脂联素水平依次降低，HOMA IR依次升高，且均有统计学意义；相关性分析显示肥胖儿童血清脂联素与TG、LDL C、FINS呈显著负相关(P<005)。结论肥胖儿童血清脂联素水平降低，并与血脂、胰岛素抵抗密切相关；与NGT肥胖组相比，IGT肥胖组儿童的血清脂联素水平进一步降低。

Analysis of the relationship between characteristics of pelvic endometriosis and chronic pelvic pain

Objective To assess whether the symptom of chronic pelvic pain (CPP) in the patients with endometriosis is related to the stage, site and morphological characteristics of the disease. Methods From July 1999 to July 2005,A total of 114 patients with laparoscopically diagnosed endometriosis and CPP were evaluated together with another 107 patients without CPP as controls in Beijing Union Hospital. A retrospective study was performed to assess the difference between these two groups considering the clinical data and the characteristics of pelvic lesion. Result In study group, there were more pain of anus and dyspareunia, more concomitant adenomyosis and more peritoneal endometriosis; however, there was less ovary endometriosis than that of the control group. The CPP symptom had no correlation with the site of peritoneal endometriosis, but was related to the depth. There was a negative correlation between the r-AFS stage and CPP. Conclusion In patients who underwent laparoscopic operations for endometriosis, concomitant adenomyosis and deeply infiltrating peritoneal endometriosis are both related to CPP symptom. The r-AFS stage has a negative correlation with CPP.