多囊卵巢综合征不同分型的临床特征及意义

目的 分析多囊卵巢综合征（PCOS）不同分型的临床超声特征及内分泌指标差异，并分析其相关性。方法 选择2010年5月-2013年5月四川省攀枝花市中心医院妇产科收治的54例不同分型的多囊卵巢综合征患者为研究对象，根据2000年世界卫生组织国际肥胖特别工作组给出的亚太地区肥胖诊断标准，将其分成肥胖组与非肥胖组，每组各27例。借助彩色多普勒血流成像测量阻力指数（RI），统计分析两组患者的超声特征，检测并比较两组患者空腹血浆胰岛素（FINS）、泌乳素（PRL）、黄体生成素（LH）、卵泡刺激素（FSH）、游离睾酮（FT）等内分泌指标。并分析各指标间的相关性。结果 肥胖组患者的卵巢体积为（12．2±4．6）mL，比非肥胖组（10．7±2．1）mL]明显增大，差异有统计学意义（P〈0．05）；肥胖组患者的FINS浓度（14．9±6．7）mU／L]、胰岛素抵抗（HOMA—IR）（4．0±3．4）明显高于非肥胖组（8．14．3）mU／L、（1．4±1．1）]，两组比较，差异有统计学意义（P〈0．05）；非肥胖组患者的FSH浓度（5．8±1．9）U／L]高于肥胖组（4．7±1．8）U／L]，差异有统计学意义（P〈0．05）；两组其余各项指标比较，差异无统计学意义（P〉0．05）。肥胖组患者子宫动脉RI与PRL浓度呈负相关（r=-0．58，P〈0．05），卵巢体积与HOMA—IR呈正相关（r=0．47，P〈0．05）。非肥胖组患者卵巢卵泡数量与LH／FSH和FT浓度呈正相关（r=0．34、0．31，均P〈0．05），卵巢体积与FT浓度呈正相关（r=0．56，P〈0．05）。结论 肥胖和非肥胖PCOS患者其超声特征以及内分泌指标存在一定的差异．并具有一定的相关性。

Clinical features and significance of polycystic ovary syndrome in different classification

Objective To analyze the clinical ultrasonography features and endocrine differences of patients with different classification of polycystic ovary syndrome （PCOS） and their correlation. Methods 54 patients with different types of PCOS from May 2010 to May 2013 in the Central Hospital of Panzhihua City in Sichuan Province were selected as study objects, and they were divided into obesity group and non-obese group according to the Asia Pacific region obesity diagnosis standard given by the 2000 WHO International Obesity Task Force, with 27 cases in each group. The resistance index （RI） of two groups were measured by the color doppler flow imaging, the endocrine indexessuch as fasting plasma insulin （FINS）, prolaetin （PRL）, luteinizing hormone （LH）, follicle-stimulating hormone （FSH）, free testosterone （FT） were detected and compared, and the correlation of those endocrine indexes were analyzed, Results Ovarian volume of obese group was （12.2±4.6） mL, larger than that of non-obese group （10.7±2.1） mL], the difference was statistically significant （P 〈 0.05）; the concentration of FINS （14.9±6.7） mU/L] and HOMA-IR （4.0±3.4） in obesity group were significantly higher than those in the non-obese group （8.1±4.3） mU/L, （1.4±1.1）], the differences were statistically significant （P 〈 0.05）; the concentration of FSH in non-obese group （5.8-＋1.9） U/L] was higher than that of the obese group （4.7±1.8） U/L], the difference was statistically significant （P 〈 0.05）; the rest indexs in the two groups had no statistically significant difference （P 〉 0.05）. In obesity group, there was negative correlation between uterine artery RI and the concentration of PRL （r=-0.58, P 〈 0.05）, and a positive correlation between the ovarian volume and HOMA-IR （r=0.47, P 〈 0.05）. In non-obese group, there was positive correlation between the number of follicles and LH/FSH, FT （r=0.34, 0.31; all P 〈 0.05）, and a positive correlation between the ovarian volume and the concentration of FT （r=0.56, P 〈 0.05）. Conclusion There were some differences in uhrasonography features and endocrine between the obese and nonobese patients with PCOS, and both have certain correlation.