N-乙酰半胱氨酸在多囊卵巢综合征中的应用研究进展

多囊卵巢综合征（PCOS）是最常见的妇科内分泌疾病之一，也是导致女性不孕的主要因素之一，其临床主要特征为稀发排卵或无排卵和高雄激素血症。研究认为PCOS是子宫内膜增生，2型糖尿病，高血压和血脂异常的重要危险因素。二甲双胍治疗对PCOS患者有益，但长期服用可引起胃肠道反应，低血糖及血清同型半胱氨酸水平升高。N-乙酰半胱氨酸（NAC）是含巯基的L-半胱氨酸的乙酰化变体，可以通过降低血清雄激素和游离睾酮水平，降低胰岛素抵抗，发挥胰岛素增敏剂作用，还可以降低机体的活性氧簇水平，最终辅助诱导PCOS患者排卵。近年来更多的研究也表明，NAC对于氯米芬抵抗的PCOS有一定疗效。综述NAC在PCOS中的治疗作用及机制。

Application of N-acetyl-L-cysteine in Polycystic Ovarian Syndrome

Polycystic ovary syndrome (PCOS), one of the most common endocrine disorders and one of the leading causes of female infertility, was characterized by oligo-ovulation, anovulation and hyperandrogenism. In addition, PCOS is a risk factor of endometrial hyperplasia, type II diabetes, hypertension and dyslipidemia. Treatment with metformin (MTF) is effective to PCOS patients. However, there are gastrointestinal side effects, hypoglycemia and the increased level of serum homocysteine in some PCOS patients treated with MTF for long term. N-acetyl-L-cysteine (NAC) is an acetylated variant of L-cysteine containing sulfhydryl groups. It has been showed that NAC can decrease the levels of serum androgen and free testosterone, decline the insulin resistance, work as an euglycemic agent, decrease the level of reactive oxidative stress (ROS) in body, and eventually play a role in ovulation induction in women with PCOS. In recent years, more and more studies have showed that NAC could have some supportive curative efficacy in PCOS patients. Here we review the role and mechanism of NAC in the treatment of PCOS.