不同类型多囊卵巢综合征患者的临床特点

目的：探讨多囊卵巢综合征（PCOS）患者内分泌紊乱的特点，为临床的个体化治疗提供依据。方法：依据2003鹿特丹诊断标准纳入PCOS患者232例，按照体质量指数（BMI，界值23 kg/m2）和黄体生成激素/卵泡刺激素比值（LH/FSH，界值2）分组。比较不同分类后患者的基础性激素水平、抗苗勒管激素、亚急性炎症反应指标及血脂代谢指标。结果：LH/FSH≥2组PCOS患者突出表现为下丘脑-垂体-卵巢轴功能紊乱，而脂代谢异常或亚急性炎症反应并不明显。BMI≥23 kg/m2组PCOS妇女具有典型肥胖所伴随的脂代谢紊乱表型，表现为高危的致心血管疾病风险倾向。结论：PCOS以BMI=23 kg/m2，LH/FSH比值2为界值区分为显著不同代谢倾向，所揭示的各类患者的内分泌代谢特点能较好地指导临床PCOS患者的个体化治疗。

Clinical Manifestations of Polycystic Ovary Syndrome Patients with Different Phenotypes

Objective：Characteristic of endocrinological disturbance in PCOS subgroups were explored to provide individualized treatment options. Methods： 232 PCOS patients were recruited and divided into subgroup according to their body mass index（BMI） and luteinizing hormone/follicular stimulation hormone （LH/FSH） ratio. Basal serum sexual hormone， Anti-müllerian hormone（AMH）， markers of lipid metabolism and subacute inflammation were analyzed. Results： PCOS patients with LH/FSH＜2 were characterized by significant hypothalamus-pituitary gland-ovary（HPO） axis dysfunction， and their metabolic disturbance or subacute inflammatary response was not significant. PCOS patients with BMI≥23 kg/m2 showed typical obesity， which is accompanied by metabolic disorder， and are highly vulnerable to cardiovascular diseases. Conclusions： The introduction of BMI=23 kg/m2 and LH/FSH=2 to classify PCOS patients appears to be of great value in category of PCOS phenotype， which would greatly improve the individualized treatment in clinic practice.