育龄期妇女体毛状况调查及其在多囊卵巢综合征诊断中的初步应用

目的探讨适合济南市多囊卵巢综合征（PCOS）患者的多毛诊断标准。方法按照Ferriman．Gallwey（F-G）体毛评价方法,对623例济南市汉族育龄期妇女（普通群体组）、131例PCOS患者（PCOS组）及84例非PCOS不孕患者（非PCOS对照组）,上唇、下颌、上臂、大腿、胸部、上腹、下腹、背上部、腰骶部9个激素相关部位与前臂、小腿2个激素无关部位的体毛分布情况进行调查;并分别以不同的临界值评价各组妇女的多毛发生率。结果（1）普通群体组妇女的激素相关部位体毛总分（F-G总分）、激素无关部位体毛总分均呈偏态分布,其第95百分位数均为2分;F-G总分与其激素无关部位体毛总分呈正相关关系（r=0．310,P〈0．01）。（2）以F-G总分≥2分为临界值,多毛发生率非PCOS对照组为4．8％（4／84）,PCOS组为48．1％（63／131）,两组比较,差异有统计学意义（X^2=47．68,P〈0．01）;以国外的多毛诊断标准F-G总分≥6分为临界值,非PCOS对照组无多毛病例,PCOS组1例,两组比较,差异无统计学意义（X^2=0．64,P=0．42）。（3）普通群体组妇女中F-G总分与年龄呈负相关关系（X^2=-0．128,P〈0．01）,与上唇、胸部、下腹的体毛评分呈正相关关系（r=0．712、0．594、0．522,P均〈0．01）。PCOS组患者F—G总分与上唇、下腹、胸部的体毛评分呈正相关关系（r=0．879、0．710、0．682,P均〈0．01）,非PCOS对照组与上唇的体毛评分密切相关（r=0．950,P〈0．01）。（4）多毛（F-G总分≥2分）发生率分别与普通群体组妇女下腹、上唇、胸部（列联系数：0．489、0．461、0．420,P均〈0．01）及PCOS组患者上唇、胸部、下腹（列联系数：0．560、0．532、0．503,P均〈0．01）相关。结论（1）F-G总分〉12分是适宜于济南市妇女的多毛诊断临界值。（2）以F-G总分〉12分为诊断标准,PCOS患者存在显著的多毛现象。（3）上唇、胸部、下腹是育龄期普通群体妇女和PCOS患者多毛的主要部位。

Investigation of body hair assessment of Chinese women in Shandong region and its preliminary application in polycystic ovary syndrome patients

OBJECTIVE: To determine a suitable standard of hirsutism for Chinese polycystic ovary syndrome (PCOS) patients living in Shandong region. METHODS: A total of 623 unbiased women from the general population in Jinan city, 131 PCOS patients and 84 controls from outpatients in Shandong region were studied with questionnaires, physical and pelvic ultrasound examination, body hair on 11 sites were evaluated, and 9 (lip, chin, arm, thigh, chest, upperbelly, lowerbelly, upperback, lowback) of them which were called hormone Ferriman-Gallwey (F-G) score and 2 (forearm, leg) sites of indifferent hormone score were calculated according to the score system described by Ferriman and Gallwey. RESULTS: (1) Both body hair F-G score and indifferent hormone score distribution mode in the or= 2 (chi(2) = 47.68, P < 0.01), but no statistic difference by F-G score >or= 6 criterion (chi(2) = 0.64, P = 0.42). (3) F-G scores were declined with age increase. The hair score on the lip, chest, lowerbelly in general population were positively correlated with F-G score (r = 0.712, 0.594, 0.522; P < 0.01) and in PCOS patients (r = 0.879, 0.682, 0.710; P < 0.01), and on the lip in controls (r = 0.950, P < 0.01). (4) The correlation contingency coefficient between hirsutism (F-G score >or= 2) and lip, chest, lowerbelly site in general population was 0.461, 0.420, 0.489 and was 0.560, 0.532, 0.503 in PCOS group respectively. CONCLUSIONS: (1) Both body hair F-G score and indifferent hormone score distribution mode are significantly different from Ferriman-Gallwey's report; according to our investigation the suitable criterion of hirsutism for Chinese women in Shandong region should be >or= 2 scores. (2) By F-G score >or= 2 standard, hirsutism is more common in PCOS than in control. (3) Lip, chest, and lowerbelly are the main sites to determine the hirsutism status of women, and the later two sites are more specific for PCOS hirsutism. Forearm and leg score can indicate hirsutism status in some degree but are not specific and sensitive for PCOS hirsutism.