多囊卵巢综合征研究新进展

多囊卵巢综合征(PCOS)是青春期和育龄妇女常见的一种主要累及生殖系统的慢性内分泌疾病.其发病机制涉及遗传、胰岛素抵抗、饮食、环境及精神心理等多种因素.其临床表现多变,主要包括高雄激素血症及胰岛素抵抗.PCOS的诊断标准有1990年美国国立卫生研究所(NIH)标准、2003年欧洲人类生殖与胚胎协会( ESHRE)/美国生殖医学会(ASRM)标准和2006年雄激素过多协会(AES)标准,都是根据专家会议共识制定的.治疗方法主要针对改善高雄激素血症和高胰岛素血症以恢复月经和排卵及改善内分泌代谢.     

多囊卵巢综合征合并非酒精性脂肪性肝病的机制与治疗

多囊卵巢综合征(PCOS)是育龄妇女中最常见的内分泌疾病，临床常表现为月经稀发或闭经、高雄激素血症、排卵障碍性不孕等，可伴有肥胖、胰岛素抵抗、高胰岛素血症、糖脂代谢紊乱等代谢异常。PCOS人群常伴发非酒精性脂肪性肝病(NAFLD)等代谢相关性疾病，PCOS与NAFLD在发病机理及治疗上均有关联。本文总结了近年来PCO合并NAFLD相关研究进展。     

多囊卵巢综合征(PCOS)患者子嗣的代谢特征

多囊卵巢综合征(PCOS)是一种家族性内分泌代谢疾病,在育龄妇女中的比例约为5%-8%,特征为月经不规则、长期无排卵、不育及高雄激素血症.约50%的PCOS患者超重或肥胖,大多数人腹部脂肪过多.此外,PCOS患者也可有其它方面的代谢异常,如胰岛素抵抗、糖耐量受损、2型糖尿病以及与脂代谢相关的异常发生率增高.     

多囊卵巢综合征的诊治进展

多囊卵巢综合征(PCOS)病因不明,与胰岛素抵抗和高胰岛素血症密切相关。因不同人群临床表现存在高度异质性,故PCOS诊断标准尚存在争议,因而PCOS生物标志物成为研究热点。PCOS治疗包括调节生活方式,改善代谢紊乱、高雄激素血症以及生殖异常。本文综述了PCOS发病特点、诊断标准及治疗方式的最新进展。     

多囊卵巢综合征易感基因多态性的研究进展

多囊卵巢综合征（PCOS）是育龄期妇女常见的生殖内分泌和代谢紊乱疾病,在育龄妇女中发病率为7％左右[1],主要表现为高雄激素血症、月经紊乱、持续不排卵、多囊卵巢等临床特征.PCOS还有许多代谢方面的影响结果,包括肥胖风险增加、胰岛素抵抗、2型糖尿病、动脉粥样硬化的过早形成.PCOS发病机制至今尚不明了.有研究表明,PCOS发病可能是不同基因参与调控的遗传性内分泌疾病,因此,相关基因的研究现已成为热点.目前关注较多的是与高雄激素相关基因、胰岛素作用相关基因及慢性炎症因子基因等.现就PCOS易感基因多态性的研究进展做一综述.     

胖和瘦的多囊卵巢综合征一样吗

多囊卵巢综合征（polycystic ovary syndrome,PCOS）是育龄妇女常见的内分泌代谢疾病,此人群中发病率介于8％ ～ 12％[1].PCOS临床异质性大,患者可以表现出月经紊乱、卵巢多囊、排卵障碍、多毛、痤疮以及糖脂等代谢异常[9].PCOS发病原因至今不清楚,已知受遗传和环境因素的双重影响[2].高雄激素血症和胰岛素抵抗、高胰岛素血症是PCOS的重要的病理生理改变.     

多囊卵巢综合征与代谢综合征

多囊卵巢综合征(PCOS)临床定义为月经过少伴随男性化现象,表现为痤疮、多毛等雄激素增高,常合并胰岛素抵抗(IR)、高胰岛素血症、黄体激素促卵泡成熟激素比值增高、腹型肥胖、不育。B超示多囊卵巢有重要诊断意义。PCOS常为糖尿病的前躯表现,应受到重视。一、PCOS和代谢综合征(MS)的相互重叠性。PCOS患者中有 30%伴有糖耐量受损( IGT), 7 5%合并糖尿病。PCOS患者与体重相当的女性对照组比较,高胰岛素血症和IR的发生率更高,程度更严重。超过 40%的 PCOS患者伴有肥胖。伴有的肥胖的患者与体重相当的对照组及低体重的PCOS患…     

多囊卵巢综合征胰岛素抵抗的评估与治疗

多囊卵巢综合征（PCOS）是青春期少女和育龄期妇女最常见的内分泌疾病,是女性不孕的常见原因,其患病率为4％～8％,一些地区甚至高达25％。该病以闭经或月经稀发、排卵障碍、高雄激素和卵巢多囊样变为主要特征。PCOS患者常伴有中心性肥胖、胰岛素抵抗、糖耐量异常（IGT）、     

11β-羟类固醇脱氢酶1与胰岛素抵抗和多囊卵巢综合征

多囊卵巢综合征(PCOS)是育龄女性中常见的内分泌紊乱性疾病,主要以胰岛素抵抗和高雄激素血症为主要病理生理改变.PCOS患者中肥胖/代谢综合征的发生率显著高于正常人群.11β-羟类固醇脱氢酶1(11β-HSD1)在体内主要参与皮质酮和皮质醇之间的转换调节.11β-HSD1的表达和(或)活性增加,使局部皮质醇水平增加,影响胰岛素信号的转导,导致胰岛素抵抗和高胰岛素血症的发生.研究发现,11β-HSD1可能参与PCOS的发生、发展.     

多囊卵巢综合征的诊断和治疗

多囊卵巢综合征是青春期及生育年龄妇女最常见的妇科内分泌疾患,以长期不排卵或稀发排卵、卵巢多囊性增大、高雄激素血症或高雄激素的临床表现为基本特征,相关的代谢失调包括胰岛素抵抗、高雄激素血症,糖代谢异常、脂代谢异常、心血管疾病危险增加。目前在中国推荐采用2003年鹿特丹专家会议的诊断标准,并根据患者有无生育要求采取不同的治疗。     

Takotsubo syndrome: the broken-heart syndrome

Takotsubo syndrome – also known as broken-heart syndrome, Takotsubo cardiomyopathy, and stress-induced cardiomyopathy – is a recently discovered acute cardiac disease first described in Japan in 1991. This review aims to update understanding on the epidemiology, pathophysiology, clinical presentation, diagnosis, and treatment of Takotsubo syndrome, highlighting aspects of interest to cardiologists and general practitioners.Key words: broken-heart syndrome, stress cardiomyopathy, Takotsubo cardiomyopathy, Takotsubo syndrome     

Myelodysplastic syndrome accompanied by Evans syndrome

Various cases of myelodysplastic syndrome (MDS) with diverse immunological disorders have been reported by many investigators. In this case report, we present a 70-year-old woman who had been diagnosed as having MDS and liver cirrhosis (LC) type C for 20 months, and who finally developed autoimmune phenomena against autologous blood cells. She was admitted to our hospital in order to evaluate her advanced anemia, thrombocytopenia and fatigue. The laboratory data at admission were as follows: hemoglobin 5.3 g/dl, red blood cell count 109 x 10(4)/microliter, white blood cell count 1,760/microliter, platelet count 4.3 x 10(4)/microliter and reticulocyte count 1.3%. The direct Coombs test was positive. In addition, anti-platelet antibody was positive, using the MPHA method. With these results, Evans syndrome secondary to MDS or LC was diagnosed. The mechanisms for the development of immunological disorders in patients with MDS or LC have not been fully elucidated. To our knowledge, this patient is one of the rare cases with MDS and Evans syndrome reported in the literature. During the generation process of autoantibodies, the role of HCV antigen in the pathogenesis of Evans syndrome was of interest in this patient.     

Broken-heart syndrome (Takotsubo syndrome)

We report on the rare case of partial anomalous return of four pulmonary veins in the right atrium and superior vena cava with intact interatrial septum in a five-year-old child. There were few symptoms in contrast with the left ventricular output dependent on the flow of the left upper lobe vein and from the lingula. Reduced compliance to the left led to a severe picture of pulmonary venocapillary hypertension in the immediate postoperative period, mitigated by an 8-mm interatrial septal defect. The patient progressed well after the intervention.     

Sweet's syndrome associated with myelodysplastic syndrome

A 49-year-old man was hospitalized because of cutaneous plaques and pancytopenia. Hematological findings, and the skin eruption suggested Sweet's syndrome associated with myelodysplastic syndrome (refractory anemia with excess of blasts; RAEB). Treatment for pancytopenia was attempted without effect. Also we tried treatment with antibiotics. The skin lesions healed and the body temperature returned to normal. This case was unusual in the association of myelodysplastic syndrome with Sweet's syndrome.     

Cronkhite-Canada syndrome associated with myelodysplastic syndrome

We report a case of Cronkhite-Canada syndrome (CCS) associated with myelodysplastic syndrome (MDS). A 54-year-old woman, diagnosed as MDS the prior year after evaluation of anemia, visited our hospital with the chief complaint of epigastric discomfort. She also had dysgeusia, alopecia, atrophic nail change, and pigmentation of the palm, all of which began several months ago. Blood tests revealed severe hypoalbuminemia. Colonoscopy (CS) showed numerous, dense, red polyps throughout the colon and rectum. Biopsy specimens showed stromal edema, infiltration of lymphocytes, and cystic dilatation of the crypt. Her clinical manifestations and histology were consistent with CCS. We prescribed corticosteroids, which dramatically improved her physical findings, laboratory data, and endoscopic findings. This is the first report of CCS in a patient with MDS.