多囊卵巢综合征患者血清抑制素、瘦素及血脂间的相关性分析

目的探讨多囊卵巢综合征(PCOS)患者的血清抑制素、瘦素、血脂之间的相关性。方法检测了45例多囊卵巢综合征患者和20例月经正常的育龄期妇女作为对照组的血清瘦素、抑制素和血脂水平。结果多囊卵巢综合征患者血清中瘦素水平与甘油三脂、总胆固醇、低密度脂蛋白胆固醇、载脂蛋白B水平呈正相关(P均<0·01),与高密度脂蛋白胆固醇水平呈负相关(P<0·01),但同样结果未能在对照组中观测到。抑制素与瘦素表现为负相关关系(P<0·05)。与对照组相比,多囊卵巢综合征患者血清瘦素水平升高(P<0·01),抑制素水平无显著差异。结论瘦素水平与血脂在一定范围内相关,与PCOS可能不存在必然的联系;瘦素与抑制素存在负相关关系;多囊卵巢综合征患者组的抑制素水平虽然与正常对照组并无差别,但抑制素可能参与了PCOS性激素分泌失调的形成。     

多囊卵巢综合征患者血清抑制素B、类胰岛素样生长因子-I的测定及临床意义

目的探讨血清抑制素B、类胰岛素样生长因子-I及性激素与PCOS发病的相关性。方法应用免疫学方法比较同期PCOS不孕患者与非PCOS不孕患者血清抑制素B、类胰岛素样生长因子-I及性激素的水平,分析其与PCOS发病的相关性。结果多囊卵巢综合征患者血清抑制素B、类胰岛素样生长因子-I、黄体生成素、雄激素水平明显高于对照组,具有差异性。结论 PCOS不孕妇女的基础血清INHB、IGF-I水平显著高于正常对照组,提示INH-B、IGF-I可能参与了PCOS发病的病理生理过程。     

多囊卵巢综合征患者血清抑制素B的检测及意义

目的:探讨抑制素B(Inh-B)水平在多囊卵巢综合征(PCOS)患者血清中的变化及与PCOS的关系.方法:2003年12月-2004年5月采用酶联免疫吸附法对30例PCOS患者和30例对照血清中Inh-B水平进行检测.结果:PCOS患者血清中Inh-B水平高于对照组,差异有显著性(P<0.01).结论:Inh-B与PCOS发生有关.检测PCOS患者血清中Inh-B水平可能有助于指导PCOS的治疗.     

多囊卵巢综合征患者血清瘦素及抑制素水平测定的临床意义

目的:探讨多囊卵巢综合征(PCOS)患者血清中瘦素、胰岛素抑制素水平变化及其临床意义。方法:检测了45例PCOS患者血清中瘦素、胰岛素、抑制素和血脂水平,与20例月经周期正常妇女进行了比较。结果:PCOS患者血清中瘦素、胰岛素和甘油三酯水平明显高于对照组(P均<0.01),而高密度脂蛋白胆固醇和载脂蛋白A水平明显低于对照组(P均<0.01),抑制素、胆固醇、低密度脂蛋白胆固醇和载脂蛋白B水平与对照组相比差异无显著性。结论:瘦素和胰岛素可作为PCOS诊断的参考指标之一;PCOS患者日后患动脉硬化症的危险性较大;抑制素虽然差异无显著性,但可能与PCOS患者性激素分泌失调的形成有关。     

多囊卵巢综合征血清抑制素B水平

目的：探讨多囊卵巢综合征(PCOS)患者的血清抑制素B(inhibinB)水平及其与体重指数(BMI)和生殖激素(LH、FSH、T、A、E2)的关系。方法：用ELISA法检测33例PCOS患者和30例正常对照的血清抑制素B水平。结果：①PCOS组和正常对照组的平均血清抑制素B水平无显著差异；②两组抑制素B水平与其BMI均呈显著负相关；③非肥胖PCOS病人的抑制素B水平与其LH水平呈显著正相关，肥胖PCOS病人和对照组的抑制素B水平与其LH水平无相关性；④两组抑制素B水平与其另外激素参数无相关性。结论：肥胖与血清抑制素B水平呈显著负相关关系；LH与抑制素B水平的正相关关系仅存在于非肥胖PCOS患者中，这种现象提示：在肥胖PCOS病人中，肥胖对抑制素B产生的抑制作用超过了LH对抑制素B产生的促进作用。     

血清内脂素水平与多囊卵巢综合征的相关性研究

目的：探讨血清内脂素水平与多囊卵巢综合征（PCOS）患者胰岛素抵抗（IR）及肥胖的相关性。方法选择 PCOS 患者23例,对照组15例,根据 BMI 将 PCOS 组分为 PCOS 肥胖组8例（BMI≥25）和 PCOS 非肥胖组15例（BMI ＜25）;对照组分为对照肥胖组7例和对照非肥胖组8例。采用 ELISA 检测各组空腹血清内脂素浓度,同时于早卵泡期检测性激素水平、空腹血糖、空腹胰岛素（FINS）,计算 BMI、腰臀比、胰岛素抵抗指数（HOMA-IR）。结果PCOS 患者血清内脂素水平高于对照组（P ＜0.05）。PCOS 肥胖组血清内脂素水平高于对照肥胖组（P ＜0.05）,而 PCOS 非肥胖组与对照非肥胖组血清内脂素水平比较差异无统计学意义（P ＞0.05）。相关性分析显示,血清内脂素水平与 BMI、睾酮、空腹血糖、FINS、HOMA-IR 呈正相关（P 均＜0.05）。结论PCOS 患者存在血清内脂素的代谢异常,其血清内脂素水平的升高可能与肥胖、胰岛素抵抗有关;血清内脂素水平可作为 PCOS 患者 IR 程度的预测指标之一。     

卵巢组织中BMP15、GPR30的表达与PCOS卵泡发育障碍的关系

目的探讨卵巢组织中骨形成蛋白15 (BMP15)、雌激素受体G蛋白偶联受体30 (GPR30)在多囊卵巢综合征(PCOS)卵巢组织中的表达及其意义。方法选取我院实施手术治疗的41例PCOS患者卵巢组织(PCOS组)、因良性肿瘤实施卵巢肿瘤切除术获取的正常卵巢组织40例(对照组),分别采用免疫组化染色检测两组卵巢组织中的BMP15、GPR30表达,进行比较分析。结果 PCOS组患者的BMI、血清E2、LH、T、HOMA-IR测定值均高于对照组(P0.05),PCOS组的血清FSH低于对照组(P0.05);PCOS组的原始卵泡中卵母细胞的GPR30蛋白阳性率显著高于对照组(P0.05),BMP15蛋白阳性表达率低于对照组(P0.05);PCOS组的初级卵泡中卵母细胞的GPR30蛋白阳性率显著高于对照组(P0.05),BMP15蛋白阳性表达率低于对照组(P0.05)。结论 PCOS患者卵巢组织中BMP15表达下调、GPR30表达上调,可能参与了卵泡发育的过程。     

SCF在PCOS患者卵巢组织中的表达

目的：探讨干细胞生长因子（stemcellfactor,SCF）在多囊卵巢综合征（polycysticovarysyndrome,PCOS）发病中的可能作用。方法：本资料通过免疫组化染色检测SCF在正常卵巢和PCOS患者卵巢组织中的表达。结果：PCOS组SCF在窦前卵泡颗粒细胞的表达明显强于正常卵巢（P〈0．05）,在囊状卵泡颗粒细胞的表达明显弱于正常卵巢（P〈0．05）。结论：SCF与PCOS的卵巢多囊样变、持续无排卵密切相关。     

雷帕霉素对脱氢表雄酮诱导PCOS大鼠卵巢组织的影响及作用机制探讨

目的 探讨雷帕霉素对脱氢表雄酮（DHEA）诱导的多囊卵巢综合征（PCOS）大鼠卵巢组织的影响及作用机制。方法 55只SD雌性大鼠适应性喂养1周后随机分为空白组（13只）、对照组（13只）及PCOS组（29只），其中PCOS组大鼠皮下注射DHEA诱导建立PCOS大鼠模型，对照组大鼠给予皮下注射大豆油，空白组全程不做任何处理。造模成功后分为空白组、对照组（腹腔注射等体积生理盐水），将PCOS大鼠分为模型对照组（腹腔注射等体积生理盐水）、低剂量组（腹腔注射雷帕霉素1 mg/kg）及高剂量组（腹腔注射雷帕霉素10 mg/kg），每组各8只大鼠，共干预28 d，给药结束后检测各组大鼠血糖、性激素水平，并进行HE、Masson、免疫组织化学染色，检测并比较组间mTOR、p-mTOR及p-P70S6蛋白表达，TUNEL法检测卵巢组织凋亡情况。结果 PCOS大鼠动情周期出现紊乱，卵巢组织中卵泡呈现多囊样变化，PCOS大鼠体重、卵巢质量、体积、相对质量、性激素水平、纤维化阳性范围均高于对照组（P均<0.05），而低剂量组和高剂量组大鼠的上述指标均低于模型对照组（P均<0.05），且卵巢组织多...     

二甲双胍联合罗格列酮治疗多囊卵巢综合征40例疗效观察

【目的】探讨二甲双胍联合罗格列酮治疗多囊卵巢综合征（PCOS）临床疗效。【方法】选择PCOS患者80例，随机分为二甲双呱联合罗格列酮治疗（治疗组）和单用二甲双呱治疗（对照组）两组，每组40例。疗程均6个月。检测并比较两组患者血清性激素水平、空腹血糖及胰岛素水平，观察卵巢的变化。【结果】治疗组治疗后促黄体生成素（LH）、睾酮（T）、空腹血糖、胰岛素、稳态模型胰岛素抵抗指数（HomaIR）、卵巢体积和卵泡数与治疗前及对照组治疗后比较均有显著性差异（P〈0．05）；治疗后两组促卵泡素（FSH）水平均有升高，但与治疗前比较无显著性差异（P〉0．05）；治疗组治疗前后HomaIR及卵巢改善显著高于对照组（P〈0．05）。【结论】两种药物联合使用治疗PCOS疗效可靠，值得临床推广。     

青春期多囊卵巢综合征患者瘦素的监测及意义

目的 通过监测青春期多囊卵巢综合征患者(PCOS)瘦素的含量,探讨瘦素与PCOS的关系,寻求青春期PCOS的分型诊断方法及肥胖型患者的疗效监测指标.方法 收集30名正常青春期志愿者(正常对照组)、30例单纯型青春期肥胖者(单纯肥胖组)和41例青春期PCOS患者(27名肥胖者和14名非肥胖者)的空腹血清标本,测定瘦素,并进行统计学分析.结果 正常对照组、单纯肥胖组、青春期PCOS肥胖组与PCOS非肥胖组瘦素分别为(19.44±6.63)、(23.09±7.39)、(42.99±9.83)、(31.92±7.02)μg/L,青春期PCOS肥胖组血清中的瘦素高于对照组和单纯肥胖组,且差异均有统计学意义(t值分别为2.903、2.714,P均＜0.05);青春期PCOS肥胖组瘦素高于青春期PCOS非肥胖组,差异有统计学意义(t=2.472,P＜0.05).结论 测定瘦素可以帮助进一步明确青春期PCOS的分型,有效指导治疗,并可以作为青春期PCOS肥胖患者治疗效果的一个监测指标.

Abstract：

Objective To discuss the relationship between leptin level and polycystic ovary syndrome (PCOS) in adolescent patients with polycystic ovary syndrome, and to explore the classification diagnosis method of adolescent PCOS and indicator for clinical monitoring of obese patients. Methods All enrolled adolescent individuals were assigned into four groups: 30 normal adolescent individuals in the control group, 30 simple adolescent obese individuals in the simple obesity group,27 obese adolescent PCOS patients in the obese PCOS group and 14 nonobese adolescent PCOS patients in the nonobese PCOS group. The fasting serum samples were prepared for leptin level measurement and analysis, Results The serum leptin level of in the control group, the simple obesity group, the obese PCOS group and the nonobese PCOS group were ( 19.44 ± 6. 63 ) μg/L vs.(23.09 ±7. 39) μg/L, (42. 99 ±9. 83) μg/L and (31, 92 ±7, 02) μg/L,respectively. Leptin in the obese PCOS group was significantly higher than that in the control group and the simple obese group (t = 2. 903 and 2. 714 respectively,Ps ＜ 0. 05 ). Conclusion Monitoring the serum level of leptin can not only aid the classification of adolescent PCOS patients and guide the treatment, but also can serve as a indicator for therapeutic monitoring of obese adolescent PCOS.     

Ultrasound criteria in the diagnosis of polycystic ovary syndrome (PCOS)

Not all women with the polycystic ovary syndrome (PCOS) on ultrasound (US) will have the syndrome, and clinical and biochemical features of PCOS may be present without US features. The sensitivity of US in detecting PCOS was, therefore, prospectively determined in 72 women (32 PCOS and 40 controls). The most sensitive features were the presence of 10 or more follicles (82% and 69% in the left and right ovary) and a peripheral distribution of follicles (81.8% and 71.9% in the left and right ovary). Although ovarian enlargement and stromal brightness were not as sensitive as the previous criteria, stromal brightness was most specific. Combining all the criteria predicted a diagnosis of PCOS or control correctly in 86.4% of cases. This study shows that established US criteria of polycystic ovaries remain of value in the diagnosis of PCOS; however, the discrepancy between the left and right ovaries is an interesting but unexplained finding.     

Sonographic visualization of normal-size ovaries during pregnancy.

OBJECTIVE: To assess the ability of ultrasound to detect ovaries of normal size during pregnancy METHODS: A prospective study of 329 women with a normal pregnancy course was undertaken; 68 were excluded from analysis because of an enlarged, cystic ovary. Of the remainder, 60 pregnancies were examined in the first trimester and 201 in the second or third trimester. The first group underwent transvaginal (TVS) and transabdominal (TAS) scanning. The second group underwent TAS examination only. RESULTS: In the first-trimester group, TVS identified both ovaries in 57 patients (95%) and transabdominal ultrasound in 20 (33.3%). In the second- and third-trimester patients, TAS visualized both ovaries in 33 patients (16.4%), and neither ovary in 120 (59.7%). Both ovaries were less visible with advancing gestational age. The right ovary showed a significant change in position during pregnancy, from about 1 cm (at 15-24 weeks) to 2.5 cm (at 30-41 weeks) cranial to the iliac spine. The left ovary was found 1 cm above the iliac spine throughout pregnancy. CONCLUSIONS: Transvaginal sonography is adequate for the visualization of both ovaries in the first trimester of pregnancy. With advanced gestational age, the ovaries were significantly less visible by TAS. Sonographic scanning of the ovaries in second and third trimester should be concentrated mainly at the level of the iliac spine. Poor sonographic visualization of both ovaries in late gestation may mandate the use of other imaging modalities.     

PPAR-γ在多囊卵巢综合征大鼠卵巢组织中的表达及意义

目的:探讨过氧化物酶增殖物激活受体-γ(PPAR-γ)在多囊卵巢综合征(PCOS)大鼠卵巢的表达与其性激素变化及胰岛素抵抗(IR)的关系。方法:应用脱氢表雄酮(DHEA)皮下注射23日龄SD雌性大鼠20d,观察卵巢巢重量及光镜(HE染色)形态学改变,应用ELISA(酶联免疫法)测定T、E2、LH、FSH及血清胰岛素、糖耐量试验,应用荧光定时定量聚合酶链反应(real-timePCR)检测PPAR-γmRNA的表达。结果:实验组卵巢重量显著高于对照组(P<0.05),实验组卵巢呈多囊样改变而黄体形体比例减少;实验组血清T、E2、FSH、空腹血糖水平显著高于对照组(P<0.05),空腹胰岛素及胰岛素抵抗指数(HOMA-IR)显著高于对照(P<0.05);在PCOS大鼠卵巢中PPAR-γ相对含量显著高于对照组(P<0.05)。结论:DHEA诱导的PCOS大鼠动物模型与PCOS患者相似,PPAR-γ在PCOS大鼠卵巢发育中起部分调节作用,并与PCOS的IR密切相关。     

Relevance of the determination of ovarian volume in adolescent girls with menstrual disorders

Pelvic ultrasound and hormonal studies were performed in 29 adolescent patients, aged 12 to 20 years, to evaluate menstrual irregularities. Patients were divided in three groups according to ultrasound ovarian volumes: group I (n = 16) both ovaries <10 cm³; group II (n = 8) one of the ovaries ≥ 10cm³; and group III (n = 5) both ovaries ≥10 cm³. Serum levels of LH, LH:FSH ratio, testosterone, and androstenedione were significantly higher (p < .05) in group III. Positive predictive value of both ovarian volumes ≥10 cm³ in terms of polycystic ovary syndrome (PCOS) was 100%, negative predictive value was 81%, sensitivity was 63%, and specificity was 100%. These data suggest that, in adolescent patients with menstrual disorders, bilateral ovarian volumes of higher than 10 cm³ are correlated with the diagnosis of PCOS. © 1996 John Wiley & Sons, Inc.     

经直肠三维超声诊断未婚青少年多囊卵巢综合征的应用

目的 探讨经直肠三维超声诊断未婚青少年多囊卵巢综合征（PCOS）的价值。方法 采用经直肠三维超声对45例PCOS患者、30例单纯卵巢多囊性改变（PCO）患者和25例正常者进行观察，分别测量其卵泡数、卵巢体积、卵巢总面积（TA）、髓质面积（SA）和髓质面积与卵巢总面积的比值（SA／TA）。结果 经直肠三维超声对未婚青少年卵巢细致结构的显示优于经腹超声，且无创、方便、清晰、敏感。PCOS患者SA、SA／TA明显高于PCO及正常对照组，差异有统计学意义（P〈0．05或P〈0．01）。结论 经直肠三维超声提高了对未婚青少年PCOS的诊断水平，与经腹超声联合应用能提高诊断准确性，减少漏诊率。SA／TA可作为辅助诊断PCOS的指标。     

经阴道彩色多普勒诊断多囊卵巢综合征的价值及超声表现

目的探究经阴道彩色多普勒诊断多囊卵巢综合征(PCOS)的价值及超声表现。方法将我院28例PCOS患者纳入观察组,同期20例健康体检女性纳入对照组。比较两组经阴道超声参数以及卵巢间质内动脉血流动力学指标,经ROC曲线评估上述指标对PCOS的诊断效能,并分析PCOS患者超声表现。结果观察组卵巢面积、卵巢体积、髓质面积大于对照组,RI低于对照组,EDV、PSV高于对照组(P<0.05)。卵巢面积、卵巢体积、髓质面积、RI、EDV、PSV诊断的ROC曲线下面积分别为0.935、0.963、0.972、0.972、0.979、0.937。观察组间质血流信号以粗状为主,对照组以星点状为主,两组间质血流信号表现比较,差异显著(P<0.05)。PCOS患者超声可见双侧卵巢增大,窦卵泡数目增多。结论经阴道彩色多普勒超声可清晰地显现卵巢内部结构,有效显示卵巢血流动力学信息,在PCOS的诊断中具有重要价值。     

超声检测PCOS患者卵巢血流动力学指标及其临床意义

目的探讨彩色多普勒超声检测多囊卵巢综合征(PCOS)患者卵巢血流动力学指标的变化特点。方法选取PCOS患者95例,另选取同期体检健康育龄期女性50例作为对照组。均接受经阴道彩色多普勒超声检查及血清激素检测,对比PCOS患者与对照组卵巢血流动力学指标及激素水平差异,并分析PCOS患者子宫、卵巢基质动脉血流特征及血流参数的特征表现。结果PCOS组患者LH、LH/FSH、T、FSH水平与对照组比较,差异有统计学意义(P<0.05),但两组E2、P、PRL水平比较差异无统计学意义(P>0.05),PCOS组患者左、右双侧子宫动脉PI、RI明显高于对照组(P<0.05);Pearson相关性分析显示双侧子宫动脉PI、RI与PRL呈负性相关(P<0.05)。结论PCOS患者存在内分泌功能紊乱与卵巢血流参数异常的现象,通过超声检查能够在一定程度上反映PCOS患者病情,结合合并症情况能够间接评估患者内分泌功能,对诊断及指导PCOS临床治疗均具有重要意义。     

Body Mass Index below Obesity Threshold Implies Similar Cardiovascular Risk among Various Polycystic Ovary Syndrome Phenotypes

Objective

The aim of this study was to determine the cardiometabolic risk factors in different polycystic ovary syndrome (PCOS) phenotypes.

Subjects and Methods

This cross-sectional study was performed between 2010 and 2011. Eighty-nine patients with PCOS and 25 age- and weight-matched healthy controls were included in the study. Patients were grouped using the Rotterdam 2003 criteria as: group 1, oligomenorrhea and/or anovulation (ANOV) and hyperandrogenemia (HA) and/or hyperandrogenism (n = 23); group 2, ANOV and polycystic ovaries (PCO; n = 22); group 3, HA and PCO (n = 22); group 4, ANOV, HA and PCO (n = 22); group 5, controls (n = 25). Laboratory blood tests for diagnosis and cardiometabolic risk assessments were performed. Insulin resistance (IR) was calculated in all patients with the homeostasis model assessment of IR (HOMA-IR) formula. An euglycemic hyperinsulinemic clamp test was performed on 5 randomly selected cases in each subgroup, making 25 cases in total, and indicated as the ‘M'' value (mg/kg/min), which is the total body glucose disposal rate.

Results

The mean BMl values of the groups were: group 1, 26.1 ± 5.3; group 2, 27.9 ± 5.2; group 3, 24.3 ± 4.2; group 4, 27.9 ± 7.5; group 5, 24.7 ± 5.2 (p > 0.05). There were no differences in the lipid profile, plasma glucose, HOMA-IR, insulin and M values between the groups (p > 0.05). Phenotypes with oligomenorrhea/anovulation (groups 1, 2 and 4) were more obese than group 3 (p = 0.039).

Conclusions

The cardiometabolic risk profile was similar among the PCOS subgroups. This finding could be attributed to the mean BMl values, which, being below 30, were not within the obesity range. Obesity appeared to be an important determinant of high cardiovascular risk in PCOS.Key Words: Polycystic ovary syndrome, Cardiovascular system, Obesity