多囊卵巢综合征病理生理的一些新认识

多囊卵巢综合征（PCOS）是以长期无排卵及高雄激素为特征的内分泌综合征，以不孕、多毛、无排卵、月经不调等为主要临床表现。PCOS超声下卵巢呈明显多囊性改变，并伴促性腺激素分泌异常。雄激素过多合成在PCOS发病中起关键性作用，膜细胞对颗粒细胞反应性增高、垂体分泌促黄体激素增多以及高胰岛素血症可能是卵巢雄激素合成过多的机制。胰岛素抵抗和肥胖的出现则可能使PCOS临床症状加剧。雄激素、胰岛素、促性腺激素和肥胖间的相互作用促成PCOS患者的生殖表型。

Some New Thoughts About the Pathophysiology of Polycystic Ovary Syndrome

Polycystic ovary syndrome（PCOS） is a common endocrine disorder, characterized by chronic anovulation and hyperandrogenism. The primary clinical manifestations of PCOS are infertility, hirsutism, chronic anovulation, menstrual irregularity, and polycystic ovaries. Excessive androgen production plays a critical role in the pathogenesis of PCOS, and the proposed mechanisms responsible for increased ovarian androgen include heightened theca cell responsiveness to gonadotropin stimulation, increased pituitary secretion of luteinizing hormone, and hyperinsulinemia. Insulin resistance and obesity may make the syndrome more severe. The interaction of androgen, insulin, gonadotropins, and obesity contributes to the reproductive phenotype of PCOS.