超声检查诊断多囊卵巢综合征价值的探讨

目的 :探讨超声检查在鉴别多囊卵巢综合征 (PCOS)与单纯卵巢多囊性改变 (PCO)中的意义及超声学参数与多囊卵巢综合征患者体内激素变化的相关性。方法 :将卵巢多囊性改变 14 4例按临床症状及内分泌检查分为多囊卵巢综合征 (PCOS)组与单纯卵巢多囊性改变 (PCO)组 ,分别测定其卵巢体积、卵巢面积、髓质面积及髓质面积 /卵巢总面积的比值 (S/TA) ,同时用化学发光酶联免疫法测定血清睾酮、雌二醇、黄体生成素、卵泡刺激素、血清泌乳素 ,并分析其与S/TA的相关性。结果 :①多囊卵巢综合征组卵巢体积、髓质面积、S/TA比值均显著高于卵巢多囊性改变组 (P均 <0 0 5 )。②S/TA比值与血清睾酮呈正相关 (P <0 0 5 )。③多囊卵巢综合征患者中S/TA比值较高组中肥胖人数较S/TA比值较低组中肥胖人数明显增多 (P <0 0 1)。结论 :①卵巢体积、S/TA比值在鉴别多囊卵巢综合征与单纯卵巢多囊性改变时具有较大价值。②S/TA比值可表示多囊卵巢综合征的严重程度 ,并推测可能与胰岛素抵抗和高胰岛素血症有关。     

多囊卵巢综合征患者葡萄糖代谢异常的诊断与处理

多囊卵巢综合征（PCOS）是育龄妇女中常见的内分泌疾病。代谢综合征是当前内分泌与代谢病领域的研究热点。尽管已有研究资料提示PCOS是代谢综合征中一个常见而且重要的组分，但两者之间的复杂关系尚未完全阐明。本文着重讨论PCOS患者葡萄糖代谢异常的病理生理学基础、诊断以及治疗策略，并简要介绍代谢综合征的工作定义。     

多囊卵巢综合征及其相关疾病超声评价

多囊卵巢综合征（PCOS）需要迅速准确的诊断方法和适当的处理。近年PCOS的诊断标准成为广泛争议的话题。卵巢超声波检查在临床的广泛应用为PCOS的诊断提供了标准，并超过卵巢腹腔镜下组织学检查或活体组织检查。经阴道超声检查和多普勒卵巢血流动力学检查，都已从观察卵巢的形态改变，转向研究子宫及卵巢间质的血流动力学改变，并对病情程度及进展进行评价，监测及评价PCOS的治疗，选择受孕时机。     

甲福明治疗多囊卵巢综合征：内分泌、代谢与生殖结局

多囊卵巢综合征(PCOS)是影响育龄妇女常见的内分泌疾病之一,卵巢出现多囊性改变是其必备的特征,但据报道卵巢的这种形态学改变占成人女性20％左右。最近的观察发现,胰岛素抵抗和血中胰岛素过高是引起PCOS出现其它内分泌改变的两个主要因素,这一发现促进了特殊治疗方法的发展,即降低胰岛素水平的治疗方法。 甲福明是一种水溶性口服制剂,由于它的抗糖尿病作用而广泛用于非胰岛素依赖型糖尿病(2型糖尿病)。甲福明增强胰岛素在肝和周围组织的敏感性,抑制肝脏葡萄糖的产     

多囊卵巢综合征及其相关疾病超声评价

多囊卵巢综合征(PCOS)需要迅速准确的诊断方法和适当的处理.近年PCOS的诊断标准成为广泛争议的话题.卵巢超声波检查在临床的广泛应用为PCOS的诊断提供了标准,并超过卵巢腹腔镜下组织学检查或活体组织检查.经阴道超声检查和多普勒卵巢血流动力学检查,都已从观察卵巢的形态改变,转向研究子宫及卵巢间质的血流动力学改变,并对病情程度及进展进行评价,监测及评价PCOS的治疗,选择受孕时机.     

关注影响女性健康的重要生殖内分泌疾病多囊卵巢综合征

        多囊卵巢综合征（polycystic ovary syndrome,PCOS）是一种病因不明的异质性疾病,是育龄女性最常见的生殖内分泌疾病,是引起女性排卵障碍性不孕、月经失调和高雄激素的重要原因。浏览更多请关注本刊微信公众号及当期杂志。     

关注影响女性健康的重要生殖内分泌疾病多囊卵巢综合征

多囊卵巢综合征（polycystic ovary syndrome,PCOS）是一种病因不明的异质性疾病,是育龄女性最常见的生殖内分泌疾病,是引起女性排卵障碍性不孕、月经失调和高雄激素的重要原因。 浏览更多请关注本刊微信公众号及当期杂志。     

多囊卵巢综合征患者代谢综合征指标分析

目的探讨多囊卵巢综合征(PCOS)患者代谢综合征(MetS)及其组分的发生特点,评估MetS组分对PCOS患者罹患MetS发生风险的预测能力。方法选择2008年9月至2012年4月在福建省妇幼保健院妇科门诊诊断为PCOS患者208例及随机招募的体检者205例。PCOS诊断标准参照鹿特丹标准,MetS诊断标准依据国际糖尿病联盟(IDF)颁布的定义。所有受试者均进行人体测量和生化指标测定,比较两组MetS及其组分的发生特点,筛选对PCOS患者罹患MetS发生风险的预测指标。结果 208例PCOS患者MetS发生率为21.15%,明显高于对照组3.41%。具有1项及以上MetS组成成分的PCOS患者高达69.23%;血脂异常是主要的代谢紊乱,其次是高血压、空腹血糖异常。腰围(WC)结合高密度脂蛋白胆固醇(HDL-C)或腰围(WC)结合三酰甘油(TG)具有对PCOS患者发生MetS风险较高的预测能力。结论对于WC≥80cm的PCOS患者,一旦具备HDL-C<1.29mmol/L或TG>1.7mmol/L就应对其进行预防MetS发生的早期干预。     

多囊卵巢综合征——复杂、多系统的内分泌代谢病

自从Stein Leventhal七十余年前描述多囊卵巢综合征（PCOS）以来，对PCOS的认识已从育龄期妇女一个生殖功能障碍的妇科内分泌常见病，转变为一个累及妇女一生的复杂、多系统的内分泌代谢疾病。现就PCOS的代谢障碍及其衍生的一些新的治疗尝试进行介绍。     

多囊卵巢综合征新的超声诊断标准—卵巢间质／卵巢总面积比

为了解通过卵巢超声形态学检查的一些参数确切鉴别多囊卵巢综合征(PCOS)及超声参数是否与患者体内激素状态紊乱有关进行回顾性分析研究。对80例闭经或月经过多患者(研究组)及30例育龄妇女(对照组)均排除甲状腺功能紊乱及应用激素的影响,以体重指数(BMI)≥25(正常范围119～25)kg/m~2为肥胖的标准,对照组及月经过少患者在月经周期2～5天行阴道B超及血清检测,闭经患者则在月经     

Co-involvement of psychological and neurological abnormalities in infertility with polycystic ovarian syndrome

Objective  

To investigate psychological distress, serum levels of monoamine neurotransmitters and their metabolites, as well as their correlation with polycystic ovarian syndrome (PCOS).     

Clinical and metabolic features of polycystic ovary syndrome.

OBJECTIVE: To explore the clinical and metabolic features of Chinese women with polycystic ovary syndrome (PCOS). METHODS: The clinical data of 273 Chinese women diagnosed as having PCOS were retrospectively studied. RESULTS: Of these women 34.8% had hirsutism, 45.1% had acne, 94.1% had some menstrual abnormality, and 96.7% had typical appearances of polycystic ovaries on ultrasonographic examination. The prevalence of overweight women was 30.4%, and the prevalence of insulin resistance was 12.8% using the glucose to insulin ratio (GIR) and 21.6% using the homesostasis model assessment (HOMA). Body mass index was significantly correlated with fasting insulin level (r=0.50), GIR (r=0.37) and HOMA (r=0.53). CONCLUSION: Menstrual abnormality and polycystic ovaries were the main clinical manifestations in this cohort of Chinese women with PCOS. The prevalence of hyperandrogenism, obesity, and insulin resistance was lower in this cohort than in women from other races with the same condition. Ethnic differences needs to be considered when studying the clinical and metabolic features of women with PCOS.     

Ultrasonographic guided ovarian stroma hydrocoagulation for ovarian stimulation in polycystic ovary syndrome.

OBJECTIVE: To evaluate the safety and effectiveness of transvaginal ultrasound guided injection of hot saline into the ovarian stroma in polycystic ovary syndrome (PCOS) cases in an office based gynecology practice under local anesthesia. SETTING: Outpatient gynecologic clinic. STUDY DESIGN: Pilot study. PARTICIPANTS: Fifty-two anovulatory infertile females diagnosed as PCOS by clinical, chemical and ultrasound criteria were recruited for the study. All cases were resistant to clomiphene citrate for more than 6 months. INTERVENTION: Injection of warm sterile saline (75C) into the ovarian stroma under transvaginal monitoring using ovum pickup needle. OUTCOME MEASURES: Cycle regularity, ovulation rate and safety were primary outcomes. Pregnancy rate and patient convenience were our secondary outcomes. RESULTS: Ovulation has been achieved in 73.1% of clomiphene citrate resistant PCOS cases and resulted in pregnancy in 26.9% of these cases. No adverse effects were recorded and the procedure was tolerable in most cases. CONCLUSION: Transvaginal ultrasound guided ovarian stroma hydrocoagulation (TOSH) in an office setting seems to be a safe, economic and practical procedure that is acceptable by the patients. If larger studies confirm its effectiveness it may be an attractive alternative to conventional ovarian drilling.     

Association of metabolic syndrome in polycystic ovarian syndrome: an observational study

Objectives

To find out the prevalence of metabolic syndrome (MBS) in women with PCOS and assess their strength of association. Methods: Total 50 apparently healthy non-pregnant PCOS subjects of 15 to 35 years were studied for having the features of MBS from May 2006 to April 2007. MBS was diagnosed by National Cholesterol Education Program’s Adult Treatment Panel III 2001 criteria. Student’s t test & Mann-Whitney U test were used for statistical analysis.

Results

21 subjects out of 50 (42%) met criteria for the MBS. 15(71.5%) belonged to 26–35 years and six (20.7%) in 15–25 years. Prevalence of waist circumference > 88 cm were noted in 34%, HDL cholesterol< 50 mg/dl in 50%, triglycerides ≥ 150 mg/dl in 40%, BP ≥130/85 mm Hg in 50% and FBS≥ 110 mg/dl in 16%. Women with higher insulin resistance and free testosterone levels significantly (P<0.01) correlated with higher prevalence of MBS.

Conclusion

The metabolic syndrome and its individual components are common in PCOS, particularly among women with hyperinsulinemia and hyperandrogenism.     

Hyperandrogenemia influences the prevalence of the metabolic syndrome abnormalities in adolescents with the polycystic ovary syndrome

Objective.?The prevalence of the metabolic syndrome (MBS) abnormalities in Italian adolescents with polycystic ovary syndrome (PCOS) was evaluated.

Design.?Retrospective chart review.

Setting.?University outpatient clinic.

Participants.?Fifty-three adolescents with PCOS.

Interventions.?Subjects underwent a physical evaluation. Fasting blood samples were taken for the evaluation of metabolic parameters.

Main outcome measures.?The prevalence of MBS abnormalities according to de Ferranti criteria was assessed.

Results.?9.4% of adolescents with PCOS had the MBS (three abnormalities). Twelve girls (22.7%) had two abnormalities. Seventeen (32.1%) of PCOS girls have no MBS abnormalities. PCOS adolescents with the MBS were more obese, insulin resistant and they had significantly higher levels of total and free testosterone. The number of metabolic abnormalities correlated with free, total testosterone, free androgen index (FAI) and body mass index (BMI). Groups with two or three abnormalities were not differentiated by BMI, insulin, lipids, blood pressure, but they were differentiated by total and free testosterone and FAI. Adolescents with the MBS have higher total and free testosterone and FAI than girls with two MBS abnormalities.

Conclusions.?The MBS and its components are present in some adolescents with PCOS, placing them at increased risk for cardiovascular disease early in adulthood. Hyperandrogenemia is a risk factor for MBS independent of obesity.     

Association between polycystic ovarian syndrome, overweight, and metabolic syndrome in adolescents

PurposePolycystic syndrome (PCOS) is associated with multiple metabolic abnormalities. Studies in the adolescent population are still limited and the results have been much different. The aim of this study was to investigate the association between PCOS, overweight, and metabolic syndrome in adolescents.Methods30 PCOS adolescents were randomly selected from a PCOS population with NIH 1990 criteria and 71 adolescents from the normal adolescents. Anthropometric, hormonal and metabolic parameters were evaluated in four sub-groups including obese and non-obese PCOS and obese and non-obese normal adolescents.ResultsThe prevalence of overweight and metabolic syndrome in adolescents with PCOS was 52% and 33.3% respectively vs 22.4% (P = 0.005) and 11.26% in control (normal) adolescents (P = 0.0001). Among all subjects, including obese and non-obese adolescents with or without PCOS, the prevalence of insulin resistance, hypercholesterolemia, central obesity, and metabolic syndrome was higher in obese PCOS with 61.5%, 46.2%, 53.8%, and 69.2%, respectively.ConclusionsObesity and IR are important risk factors for metabolic syndrome in PCOS. Considering the long-term health risks, it is necessary to identify metabolic disorders in adolescents with PCOS as early as possible.