PCOS患者血浆leptin和血清T、E2、FSH、LH、PRL检测的临床意义

目的：探讨多囊卵巢综合征（PCOS）患者血浆leptin和血清T、E2、FSH、LH、PRL水平的变化及临床意义。方法：应用放射免疫分析和发光法对31例PCOS患者进行了血浆leptin和血清T、E2、FSH、LH、PRL测定,并以正常妇女作对照。结果：PCOS患者血浆leptin和血清T、LH、PRL水平非常显著地高于正常妇女组（P〈0.01）,FSH、E2水平与正常妇女组比较无显著性差异（P〉0.05）,且血浆leptin水平与血清T、LH、PRL水平呈正相关（r=0.5784、0.5411、0.6082,P〈0.01）。结论：检测PCOS患者血浆leptin和血清T、E2、FSH、LH、PRL水平的变化与疾病的发生和发展密切相关。     

IL1ra、TNFα、US-CRP与多囊卵巢综合征发病的相关性研究

目的探讨血清炎症因子白细胞介素1受体拮抗剂（IL1ra）、肿瘤坏死因子（TNFα）、血超敏C反应蛋白（US-CRP）与多囊卵巢综合征（PCOS）发病的关系。方法采用酶放大化学发光法分别检测30例PCOS无糖尿病患者及30例正常对照组血清卵泡刺激素（FSH）、黄体生成素（LH）和睾酮（T）水平;葡萄糖氧化酶法测定血清空腹血糖（GLU）水平;酶联免疫吸附试验（ELISA）方法血清IL1ra、TNFα水平;用乳胶增强免疫比浊法检测血清US-CRP水平。并用统计学方法分析两实验组中各血清成分水平差异,以及各检测指标之间的相关关系。结果（1）PCOS组LH、T、LH/FSH、IL1ra、TNFα、US-CRP水平明显高于正常组,PCOS组FSH水平低于对照组,差异有显著性（P〈0.05）。（2）PCOS组血清IL1ra、TNFα、US-CRP、T水平与体重指数（BMI）呈正相关（P〈0.05）。（3）PCOS组血清IL1ra、TNFα、US-CRP水平与LH/FSH和睾酮水平呈正相关（P〈0.05）。（4）两组血清IL1ra、US-CRP、TNFα水平存在正相关。结论炎症因子IL1ra、TNFα、US-CRP在多囊卵巢综合征患者血清中明显升高,提示慢性亚临床炎症可能与多囊卵巢综合征发病相关。     

多囊卵巢综合征和其它妇科疾病患者血清激素水平的测定

目的探讨了9个指标（E2、LH、FSH、PRL、P、T、INS、SHBG、FTI％）在多囊卵巢、月经不调和其他妇科疾病时的异常率差别,为临床选择激素检查提供依据。方法采集多囊卵巢、月经不调和其他妇科疾病患者血清,应用电化学发光分析检测,结果参考值相比,计算异常率,统计学处理。结果PCOS患者SHBG、FTI％、T和LH的异常率分别为（34％、44％、15％和45％）明显高于其他两组且差异显著,SHBG、FTI％异常率明显高于T。结论对PCOS患者应首选LH、FSH、SHBG和FTI％以提高检测结果的异常率。     

多囊卵巢综合征患者血清抑制素B水平的分析

目的：探讨抑制素B（inhibin,INH-B）水平在多囊卵巢综合征（PCOS）患者血清中的变化及其与体重指数（BMI）的关系。方法：筛选PCOS患者40例,根据体重指数（BMI）分为肥胖组和非肥胖组并检测血清中的抑制素B（INH-B）、胰岛素生长因子-I（IGF-I）、空腹胰岛素（In）、瘦素（leptin）、黄体生成素（LH）、卵泡刺激素（FSH）、人体催乳素（PRL）、雌二醇（E2）和睾酮（T）,另取40例排卵正常、无怀孕妇女做对照分析。结果：PCOS患者肥胖组leptin、In、LH、T水平明显高于非肥胖组,INH-B、IGF水平则明显低于非肥胖组,差异有统计学意义（P〈0.05）;且肥胖组的LH与INH-B呈负相关（r=-0.735,P〈0.05）,非肥胖组的LH与INH-B无明显相关性。非肥胖组INH-B、IGF、LH、T水平明显高于对照组,差异有统计学意义（P〈0.05）。结论：INH-B与多囊卵巢综合征（PCOS）发生有关,且作为PCOS特征的肥胖又影响着INH-B的作用和水平。     

瘦素与多囊卵巢综合征的相关分析

目的探讨血清中瘦素（Leptin）水平与多囊卵巢综合征（PCOS）的关系。方法采用免疫化学发光法检测68例PCOS患者和32例正常妇女血清中的廋素、性激素水平,同时进行糖耐量及胰岛素释放试验。结果 PCOS组血清瘦素水平明显高于对照组（P〈0.05）;PCOS组与对照组相比,除E2水平无显著性差异（P〈0.05）外,其余各项LH、T、PRL、FSH、A4差异显著（P〈0.05）;PCOS组中非肥胖与肥胖组间,除了T、A4差异显著（P〈0.05）外,其余指标差异均无统计学意义（P〈0.05）;PCOS组中瘦素与FINS（r=0.726,P〈0.01）、IR（r=0.631,P〈0.01）、AUC（r=0.518,P〈0.01）、ISI（r=0.663,P〈0.05）均呈正相关关系。结论瘦素可能参与PCOS的发生、发展,并与胰岛素抵抗、高胰岛素血症密切相关。     

PCOS患者卵巢超声形态学改变与内分泌激素相关性的初步研究

目的探讨多囊卵巢综合征（PCOS）患者卵巢的形态学改变与内分泌激素的相关性。方法选择94例PCOS患者作为研究组,按体质量指数（BMI）分为肥胖型PCOS组（OB-PCOS）和非肥胖型PCOS组（NOB-PCOS）;同期选择69例有正常排卵的输卵管性不孕患者作为对照组,经阴道超声分别测量其卵巢总面积（A）,同时检测其黄体生成素（LH）、卵泡刺激素（FSH）、睾酮（T）、雌二醇（E2）、人体催乳素（PRL）水平,并分析其与A值之间的相关性。结果 1.PCOS组卵巢总面积明显高于对照组（P〈0.001）,LH、LH/FSH以及T水平较对照组明显升高,差异有统计学意义（P〈0.001）,FSH水平明显降低,差异有统计学意义（P〈0.05）;2.PCOS患者肥胖型组T水平较非肥胖型组升高,差异无统计学意义（P〉0.05）;3.相关性分析显示,PCOS组A值与T值呈正相关,差异有统计学意义（P〈0.05）。结论 PCOS的发病过程中,卵巢总面积的改变受内分泌激素的影响。     

男性不育症患者血清IL-6、T、LH、FSH、PRL检测的临床意义

目的：探讨了男性不育症患者血清IL-6、T、LH、FSH和PRL水平的变化及临床意义。方法：应用放射免疫分析对68例男性不育症患者进行了血清IL-6、T、LH、FSH和PRL检测,并与35名男性正常人作比较。结果：男性不育症患者血清T水平非常显著地低于男性正常人组（P〈0.01）,而IL-6、FSH、LH和PRL水平又非常显著地高于男性正常人组（P〈0.01）。血清IL-6水平与T水平呈负相关（r=-0.4186,P〈0.01,与FSH、LH和PRL水平呈正相关（r=0.6018、0.5912、0.6214,P〈0.01）。结论：检测男性不育症患者血清IL-6、T、LH、FSH和PRL水平的变化对诊断、预后判断及治疗均有较大的实用价值。     

GDF9在PCOS患者成熟卵泡中的表达及其与内分泌激素的相关性

目的：探讨卵源性因子生长分化因子9(GDF9)在多囊卵巢综合征（PCOS）患者控制性卵巢刺激促排周期成熟卵泡中的表达,及其与内分泌激素的相关性。方法：选取115例接受体外受精控制性卵巢刺激治疗不孕患者,包括PCOS患者61例和卵巢功能正常的对照组54例。于取卵日获取成熟卵泡的卵泡液和卵丘细胞。比较两组患者一般资料及月经周期第3～5天的基础内分泌激素情况。采用ELISA法检测两组患者的卵泡液GDF9蛋白浓度;免疫组化法检测其卵丘细胞上GDF9蛋白表达水平;Pearson相关分析评估GDF9表达与血清睾酮（T）、卵泡刺激素（FSH）、黄体生成素（LH）和抗缪勒管激素（AMH）水平的相关性。结果：PCOS患者成熟卵泡GDF9表达水平明显低于对照组（P<0.01）,相关性分析显示PCOS患者卵泡液GDF9水平与T和FSH呈正相关;与LH、LH/FSH和AMH呈负相关（P<0.05）。而在对照组中,GDF9与T、FSH、LH、LH/FSH和AMH无显著相关性（P>0.05）。结论：GDF9在PCOS患者成熟卵泡中表达水平降低,并与血清T、FSH、LH、LH/FSH和AMH相关。     

多囊卵巢综合征患者血清相关性腺激素结果分析

目的本文主要探讨血清总睾酮(total testosterone,TT)、雄烯二酮(androstendione,AND)以及促黄体生成素(luteinizing hormone,LH)/促卵泡刺激素(follicle stimulating hormone,FSH)比值对多囊卵巢综合征(PCOS)的诊断灵敏度,PCOS患者血清AND与TT、LH、FSH浓度及LH/FSH比值是否具有相关性,以及探究不同年龄段PCOS患者血清各相关生化指标是否有显著差异。方法回顾性地分析了121例PCOS患者血清生化指标,包括 LH、FSH、AND、TT和计算出的 LH/FSH 比值。PCOS 患者经临床表现、体格检查、血清 TT 测定结合卵巢彩超结果确诊,根据年龄以20岁为界将患者分为青春期和成年期两组。结果经统计,PCOS 患者血清 TT 阳性率为59%,AND 阳性率为62%,有33%的患者LH/FSH比值大于2。TT联合AND检测可以提高PCOS的诊断灵敏度至74%。TT 与 AND 经Pearson 相关性分析, P =0.006(<0.05 ),有线性相关关系,且为正相关,LH、FSH 和 LH/FSH 比值与 TT、AND 均无线性相关关系。经 t 检验分析,在青春期与成年期两组 PCOS 患者间,青春期组患者的血清 TT 水平与成年期组相比,青春期组明显高于成年期组,差异有统计学意义, P =0.002(<0.05)。两组的AND、LH、FSH 水平和 LH/FSH 比值差异均无统计学意义。结论本研究表明血清TT 联合AND 检测可以提高PCOS 患者的诊断灵敏度,PCOS 患者血清AND浓度与TT 呈线性正相关,与LH、FSH浓度及LH/FSH比值均不具有线性相关关系。青春期患者血清TT明显高于成年期组,AND、LH、FSH浓度及LH/FSH比值差异无统计学意义。     

多囊卵巢综合征患者血清前列腺特异抗原水平

研究多囊卵巢综合征（PCOS）患者血清前列腺特异抗原（PSA）是否升高。正常对照组50名,PCOS组40例,分别测定血清PSA、睾酮（T）、性激素结合球蛋白（SHBG）、硫酸脱氢表雄酮（DHEA-S）水平,对两组测定值进行统计学分析。正常对照组血清PSA值为3.56±0.44pg/mL,PCOS组为15.64±3.36pg/mL,两组值有显著性差异（P〈0.01）。血清PSA值与T、DHEA-S值之间有弱的正相关关系（分别为r=0.467P〈0.01;r=0.205,P〈0.05）;与SHBG值之间有弱负相关关系（r=-0.260,P〈0.05）。PCOS患者血清PSA水平高于正常人,PSA可作为女性雄激素增高的标志物而在临床应用。     

PCOS患者血清ADP和INS水平的相关性分析

目的：探讨了多囊卵巢综合征（PCOS）患者血清脂联素（ADP）和胰岛素（INS）水平的相关性。方法：采用放射免疫分析对36例PCOS患者进行了血清ADP和INS测定,并与35名正常人为对照。结果：PCOS患者血清ADP水平非常显著地低于正常人组（P〈0.01）,而血清INS水平则显著地高于正常人组（P〈0.01）。两者呈明显的负相关（r=-0.5034,P〈0.01）。结论：PCOS患者血清ADP和INS水平密切相关,对判断病情的严重程度、病情的发展均具有重要的临床价值。     

Hyperinsulinemia in polycystic ovary syndrome: relationship to clinical and hormonal factors

We analyzed the association between hyperandrogenism and hyperinsulinemia, and their relationship to body mass index, in a large series of patients with polycystic ovary syndrome (PCOS). A characteristic hormonal profile was sought in women with marked hyperinsulinemia. The patient group consisted of 73 women with PCOS, ranging in age from 16 to 29 years. The control group consisted of 34 healthy women with no evidence of hyperandrogenism, aged 19–30 years. None of the patients or control women had a body mass index above 27 kg/m². Follicle-stimulating hormone, luteinizing hormone, prolactin, testosterone, estradiol, androstenedione, dehydroepiandrosterone sulfate, sex hormone binding globulin, 17-hydroxyprogesterone, and free cortisol were determined by radioimmunoassay. The free testosterone index was calculated. The oral glucose tolerance test was used to analyze basal insulinemia, maximum insulin peak, and the insulinemia/glycemia index. In the group with PCOS body mass index was greater, free testosterone index was higher, and levels of dehydroepiandrosterone sulfate, testosterone, 17-hydroxyprogesterone (P < 0.001) and androstenedione (P < 0.05) were higher than in the control group. Of the insulin parameters, basal insulinemia, maximum insulin peak, and insulinemia/glycemia index were higher in the patient group (P < 0.001). In patients with marked insulinemia, free testosterone index was more markedly elevated, and gonadotrophin levels were normal. Our data confirm that a characteristic pattern of hyperinsulinemia is associated with PCOS. We found no causal relationship between hyperinsulinemia and androgen levels. A characteristic hormonal pattern was found in patients with marked hyperinsulinemia.Abbreviations BMI body mass index - 17OHP 17-hydroxyprogesterone - DHEAS dehydroepiandrosterone sulfate - FTI free testosterone index - I/G insulin/glucose ratio - OGTT oral glucose tolerance test - PCOS polycystic ovary syndrome - P_max maximun peak of insulin - SHBG sex hormone binding globulin - LH luteinizing hormone - FSH follicle-stimulating hormone     

The (TAAAA)n microsatellite polymorphism in the SHBG gene influences serum SHBG levels in women with polycystic ovary syndrome

BACKGROUND: Hyperandrogenaemia is a common feature of polycystic ovary syndrome (PCOS). The sex hormone-binding globulin (SHBG) gene was proposed as being a PCOS candidate gene. A possible influence of the microsatellite polymorphism (TAAAA)(n) in the SHBG gene on serum SHBG levels in PCOS patients was investigated. METHODS: One hundred and twenty-three PCOS patients and 110 age-matched controls were included in the study. Peripheral blood samples were obtained. Genotyping of the (TAAAA)(n) polymorphism in the SHBG gene was performed. Serum LH, FSH, SHBG and total testosterone concentrations were determined. RESULTS: SHBG alleles with 6-11 TAAAA repeats were found. None of the SHBG alleles or genotypes were present at a significantly more frequent rate in PCOS patients compared with controls. Serum SHBG levels were significantly lower (P < 0.001) in PCOS patients compared with controls and were found to be strongly influenced by the (TAAAA)(n) SHBG polymorphism, in both the PCOS (55.3%) and control (33.1%) groups of patients. CONCLUSIONS: The (TAAAA)(n) SHBG gene polymorphism might be an important predictor for serum SHBG levels and, consequently, for hyperandrogenaemic clinical presentation of PCOS.     

多囊卵巢综合征IGF-Ⅰ、IGFBP-1相关因素探讨

目的探讨多囊卵巢综合征(PCOS)患者胰岛素生长因子-Ⅰ(IGF-Ⅰ)、胰岛素生长因子结合球蛋白-1(IGFBP-1)水平与肥胖、性激素、糖代谢各项指标之间的关系。方法测定31例PCOS研究组和29例健康对照组IGF-Ⅰ、IGFBP-1水平及肥胖、性激素、糖代谢各项指标,比较两组间差异;分析研究组IGF-Ⅰ、IGFBP-1水平与其他各项指标之间相关性。结果研究组IGFBP-1,性激素结合球蛋白(SHBG)低于对照组,体重指数(BMI),臀围比值(WHR),多毛评分(F-G评分),黄体生成素(LH),黄体生成素/卵泡刺激素(LH/FSH),总睾酮(T),游离睾酮(FT),雄烯二酮(A2),硫酸脱氢表雄酮(DHEAS),空腹胰岛素(FINS),胰岛素抵抗指数(HomaIR)高于对照组,差异均有显著性(P0.001～0.05),IGF-Ⅰ,FSH,雌二醇(E2),17羟孕酮(17-OHP),泌乳素(PRL),空腹血糖(FBG)差别无显著性(P0.05)。研究组中IGFBP-1与BMI呈负相关(r=-0.372,P0.05),与FINS呈负相关(r=-0.481,P0.01),与SHBG呈正相关(r=0.504,P0.01),IGF-Ⅰ与各指标之间无明显相关性。结论 IGFBP-1与PCOS患者肥胖、空腹胰岛素水平密切相关。     

PCOS患者治疗前后血清hs-CRP、IL-6和TNF-α检测的临床意义

目的：探讨了多囊卵巢综合征（PCOS）患者治疗前后血清hs-CRP、IL-6和TNF-α水平的变化及临床意义。方法：应用放射免疫分析和免疫比浊法对31例PCOS患者进行了血清hs-CRP、IL-6和TNF-α检测,并与35名正常人作比较。结果：PCOS患者在治疗前后血清hs-CRP、IL-6和TNF-α水平非常显著地高于正常人组（P〈0.01）,经治疗后6个月则与正常人组比较无显著性差异（P〉0.05）,且血清hs-CRP、IL-6和TNF-α水平呈正相关（r=0.6014、0.5982,P〈0.01）。结论：检测PCOS患者血清hs-CRP、IL-6和TNF-α水平的变化与疾病的发生和发展密切相关。     

SHBG、DHEAS与多囊卵巢综合征的相关性

论述了多囊卵巢综合征的内分泌机制,以及多数患者血清中性激素结合球蛋白（SHBG）与硫酸脱氢表雄酮（DHEA-S）两者之间的关系。     

Clinical, endocrine and metabolic effects of acarbose, an alpha-glucosidase inhibitor, in PCOS patients with increased insulin response and normal glucose tolerance

BACKGROUND: The aim of this study was to evaluate whether treatment with acarbose, an alpha-glucosidase inhibitor, improved hyperandrogenic symptoms, insulin and androgen serum concentrations in hyperinsulinaemic patients with polycystic ovary syndrome (PCOS). METHODS: 30 hyperinsulinaemic women with PCOS and 15 controls were evaluated. Patients were randomized, using a computer-generated randomization list, into two groups of 15 each and treated with placebo or 300 mg/day of acarbose for three months. Hirsutism and acne/seborrhoea scores, hormonal and sex hormone binding globulin serum concentrations, glycaemia and insulin responses to a standard oral glucose load (75g) were measured in all patients before and after three months of treatment. RESULTS: A significant reduction of the acne/seborrhoea score was observed in patients treated with acarbose and eight of them resumed a regular menstrual rhythm. These clinical improvements were associated with a significant reduction of the insulin response to glucose load, a significant decrease of LH, total testosterone and androstenedione and with a significant increase of sex hormone binding globulin serum concentrations. The serum concentrations of FSH, dehydroepiandrosterone sulphate, prolactin and 17alpha-hydroxyprogesterone did not change significantly. No clinical, metabolic and hormonal modifications were observed in PCOS patients treated with placebo. CONCLUSIONS: This is the first report showing a reduction of the acne/seborrhoea score in hyperinsulinaemic patients with PCOS treated with acarbose. This improvement was associated with a significant decrease of the insulin response to oral glucose load and of LH and androgen serum concentrations and with a significant rise of sex hormone binding globulin concentration.     

两种SD大鼠多囊卵巢综合征模型的比较研究

目的比较两种SD大鼠多囊卵巢综合征动物模型的建模效果。方法建立两种PCOS动物模型。观察各组大鼠卵巢形态学、性激素及空腹血糖和胰岛素的变化。结果DHEA建模组大鼠的体重显著低于对照组（P〈0．05）;hCG建模组大鼠卵巢重量和体积均显著高于对照组（P〈0．05）。两建模组大鼠卵巢卵泡多呈囊性扩张,颗粒细胞层数减少,卵泡膜细胞、间质细胞增生。两建模组大鼠血清T、FINS、FBG和HOMA指数均显著高于对照组（P〈0．05）;DHEA建模组LH水平较对照组无显著性差异;hCG建模组大鼠血清LH、LH／FSH比值均显著高于对照组（P〈0．05）。DHEA建模组FSH水平显著高于对照组（P〈0．05）。结论利用hCG诱导SD幼年雌性大鼠出现了与PCOS患者极为相似的卵巢病理改变及LH、雄激素水平升高和胰岛素抵抗等典型内分泌变化,其建模效果优于DHEA。