多囊卵巢综合征患者非酒精性脂肪性肝病发病情况分析

目的 分析多囊卵巢综合征(PCOS)患者中非酒精性脂肪性肝病(NAFLD)的发病情况.方法 选择PCOS患者60例为PCOS组、非PCOS患者60例为对照组,比较两组患者NAFLD的发病情况.结果 PCOS组丙氨酸转氨酶(AIJT)水平、空腹胰岛素水平和稳态模型胰岛素抵抗指数(HOMA-IR)分别为(29±15)U/L、(19±12)mU/L和0.47±0.29,均显著高于对照组[分别为(15±13)U/L、(11±8)mU/L和0.31±0.21],差异均有统计学意义(P＜0.05).PCOS组胰岛素抵抗、NAFLD的发生率分别为63%(38/60)和42%(25/60),与对照组的35%(21/60)和20%(12/60)比较,差异有统计学意义(P＜0.05).PCOS组ALT异常的发生率为40%(24/60),对照组为3%(2/60),两者比较,差异有统计学意义(P＜0.01).PCOS组伴有NAFLD患者与不伴NAFLD患者比较,体重指数显著增高,差异有统计学意义(P＜0.01);腰围臀围比值、ALT、C反应蛋白、空腹胰岛素、口服葡萄糖耐量试验2 h后胰岛素水平和HOMA-IR也显著升高,差异也有统计学意义(P＜0.05).结论 PCOS患者中NAFLD患病率升高,提示了两种疾病在临床上的相关性及对PCOS患者进行肝脏相关检查的必要性.

Prevalence of nonalcoholic fatty liver disease in pafients with polycystic ovary syndrome:a casecontrol study

Objectlve To examine the metaphase Ⅱ spindle and chromosome configurations of human oocytes cultured for different times after thawing.Methods Using slow-cooling and raid-thawing protocol combined with 0.3 mol/L sucrose and 1.5 mol/L 1,2-propanedio 1(1,2-PROH)to cryoprotect human mature oocytes(n=102),the 64 survival oocytes without abnormal zona pellucida and cytoskeletal were randomly assigned to three groups after thawing:group A:culture 1 hour(n=20),group B:culture 3 hour(n=22),group C:culture 5 hours(n=22),the fresh oocytes served as control group(n=18).Immunocytochefifical staining and fluorescence microscopy were used to assess the morphology of the metaphase Ⅱ spindle and chromosome.Results (1)The normal spindle rates of groups A,B and C were 10％(2/20),46％(10/22)and 41％(9/22)respectively,significantly decreased compared with control group (83％,15/18;P＜0.05).The rates of absent spindle in group A(45％,9/20)was significantly higher than control group(6％,1/18;P＜0.01).Also,the rates of absent spindle in group A was higher than groups B (14％,3/20)and C(14％,3/20;P＜0.05).However,no significant differences were observed in groups B and C(P＞0.05).(2)A significant increase in abnormal chromosome rate was observed in group A(30％,6/20)compared to groups B(68％,15/22),C(64％,14/22)and control group(78％,14/18;P＜0.05).No differences in chromosome morphology were observed in groups B,C and control group(P＞0.05).Conclusions The cryoprotectant protocol leads to a deleterious effect on the organization of the meiotic spindle and chromosome at MⅡ stage.The 3-5 hours post-thawing incubation could permit restoration of the meiotic spindles and chromosome.