关键词： 多囊卵巢综合症   DNA甲基化   动物模型  

摘要： 目的 复制一种理想的多囊卵巢综合征（PCOS）动物模型，并检测LHR、INSR和AR基因DNA甲基化状态。方法 给模型组24日龄大鼠皮下埋植左旋18-甲基炔诺酮硅胶棒3mm/只，3d后每日2次皮下注射人绒毛膜促性腺激素1.5 IU。给对照组皮下注射等体积生理盐水。注射9d后观察大鼠卵巢形态学（HE染色）、放射免疫法测定性激素和空腹胰岛素水平、己糖激酶法测定空腹血糖水平、计算胰岛素抵抗（HOMA）指数。用甲基化特异性PCR检测LHR、INSR和AR基因的DNA甲基化状态。结果 模型组大鼠卵巢重量和体积均显著高于对照组（P＜0.001）。模型组卵巢各级发育期卵泡及黄体少见，卵泡多呈囊性扩张。模型组大鼠血清孕激素、睾酮、促黄体生成激素（LH）、空腹胰岛素、空腹血糖水平均显著高于对照组（P均＜0.05）；LH/促卵泡生长激素（FSH）比值和HOMA指数也均显著高于对照组（P均＜0.001）。模型组INSR基因甲基化率为76.7%，显著高于对照组（20.0%）（P＜0.001）。结论 DNA甲基化介导的胰岛素受体基因转录抑制是PCOS胰岛素抵抗发生机制之一。

关键词： 经阴道超声   卵巢间质面积/总面积比值   多囊卵巢综合症   胰岛素抵抗  

摘要： 目的探讨应用超声检测卵巢间质面积(S)、总面积(A),计算S/A比值诊断多囊卵巢综合症(PCOS)的价值。方法对50例PCOS患者(PCOS组)和52例有正常排卵的不孕症患者(对照组)行阴道超声(TVS)检查,测量卵巢S、A,计算S/A比值;检测两组患者的血清睾酮(T)、黄体生成素(LH)、卵泡刺激素(FSH),计算LH/FSH比值。并对PCOS组检测空腹血糖(FPG)和空腹胰岛素(FIN),计算稳态模型指数(HOMA-IR)来评估胰岛素抵抗。结果PCOS组S、S/A比值显著高于对照组(P<0.01)。PCOS组S、S/A比值与T、LH、LH/FSH比值呈正相关,与FSH无相关性。PCOS组S/A比值与HOMA-IR呈正相关。结论S/A比值、S可作为辅助诊断PCOS的指标。

关键词： 多囊卵巢综合症   健脾化痰活血法   胰岛素抵抗   瘦素   临床研究  

摘要： 目的观察中药健脾化痰活血法改善PCOS患者的临床症状(如月经不调、多毛、痤疮、BBT等),及对胰岛素、瘦素的影响情况,并进一步探讨其作用机理。方法选择门诊PCOS患者65例,予中药健脾化痰活血方治疗。1个月经周期为1个疗程,共治疗3个疗程。3个疗程后综合判定疗效,通过统计学方法处理。结果中药健脾化痰活血法能有效的改善PCOS患者的临床症状,并改善胰岛素抵抗及降低血清瘦素水平。结论中药健脾化痰活血法治疗PCOS疗效显著。

关键词： 多囊卵巢综合征   中西医结合  

摘要： 目的探讨治疗多囊卵巢综合征(PCOS)的有效治疗方法。方法选择86例PCOS患者,服中药治疗3个月经周期,停1个月,第5个月经周期开始服氯米芬(CC)促排卵,监测治疗前后激素水平及卵泡发育情况。结果服药4周期血清生殖激素均有所改善,双侧卵巢体积缩小,卵泡明显减少(P<0.01)。治疗8周期症状基本缓解、有排卵者共64例(74.42%),28例妊娠(32.568%)。结论中药联合CC促排卵治疗PCOS,可使子宫、卵巢形态及生殖激素明显改善,并能提高排卵率和受孕率。

关键词： GRADE CHRONIC INFLAMMATION   CARDIOVASCULAR RISK   ENDOTHELIAL DYSFUNCTION   METABOLIC SYNDROME   OVERWEIGHT WOMEN   YOUNG-WOMEN   DISEASE   OBESITY   MARKER   LIVER  

摘要： Objective: increased serum C-reactive protein (CRP). an independent predictor of coronary heart disease. was reported in women with polycystic ovary syndrome (PCOS). It remains unclear whether this finding is due to the association between PCOS and either insulin resistance, obesity. or androgen excess, which are all common features of this condition. The aims of this study were to assess whether increased serum CRP is a specific feature of PCOS and to investigate the mechanisms underlying this association. Design and methods: Serum high-sensitivity CRP (hs-CRP) was measured in 86 hyperandrogenic women (age 21.6 +/- 4.2 years, body mass index (BMI) 23.6 +/- 3.5 kg/m(2)). 50 with PCOS and 36 with idiopathic hyperandrogenism (HA). Thirty-five BMI-matched healthy women were also Studied as controls. In these subjects. endocrine and metabolic profiles were assessed. In all hyperandrogenic subjects and 14 controls. insulin Sensitivity was measured by the glucose clamp technique. Body fat was measured by bioelectrical impedance. Results: Hs-CRP concentrations were higher in PCOS women (3.43 +/- 2.01 mg/l) than in HA Subjects and healthy women (2.43 +/- 1.04, P<0.005; and 2.75 +/- 0.86 mg/l, P<0.05 respectively versus PCOS). In Multiple regression analyses, increased serum hs-CRP was independently predicted by higher body fat and tower insulin sensitivity However, in lean women. serum-free testosterone was an additional. negative. predictive variable. Conclusions: PCOS is accompanied by it low-grade chronic inflammation. Body fat appears the main determining factor of this finding, which is only partly explained by insulin resistance. At least in lean women. androgen excess per se seems to play an additional. possibly protective, role in this association.

关键词： 临床医药   医学教育   答题卡   缺血性心脏病   多囊卵巢综合症   基质金属蛋白酶   病毒载体   始动因素   高胰岛素血症   细胞外基质  

关键词： Hispanic   adolescents   overweight   insulin resistance   glucose intolerance   polycystic ovary syndrome   SENSITIVITY CHECK INDEX   HOMEOSTASIS MODEL ASSESSMENT   TYPE-2 DIABETES-MELLITUS   INSULIN SENSITIVITY   FASTING GLUCOSE   OBESE CHILDREN   PREMATURE ADRENARCHE   CLAMP TECHNIQUE   UNITED-STATES   SYNDROME PCOS  

摘要： OBJECTIVES: About one third of overweight women with polycystic ovary syndrome (PCOS) have either impaired glucose tolerance (IGT) or type 2 diabetes mellitus (DM) by the age of 30. We sought to determine if overweight Hispanic adolescents with PCOS are more likely to be insulin resistant and glucose intolerant than those without PCOS. METHODS: A retrospective chart review of 101 subjects with PCOS and 40 without PCOS was conducted. Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), Quantitative Insulin Sensitivity Check Index (QUICKI), and fasting glucose/insulin ratio (FGIR) values were calculated by using fasting glucose and insulin levels. Insulin resistance (IR) was defined as a fasting insulin level of > 15 mu U/mL, a 2-hour insulin level of > 75 mu U/mL, a HOMA-IR value of > 3.16, a QUICKI value of < 0.357, and/or a FGIR value of < 7. RESULTS: Of the 101 overweight subjects with PCOS (BMI: 33.2 +/- 5.9 kg/m(2)), 4 had IGT and 2 had DM versus none of the 40 subjects without PCOS (BMI: 32.4 +/- 5.3 kg/m(2)). IR was more frequent in the overweight PCOS than in the overweight non-PCOS group (QUICKI: 68.4% vs 14.3%, P = .014) and FGIR (47.4% vs 0%, P = .024). Of the 6 subjects with glucose intolerance, only the QUICKI value was abnormal in all. CONCLUSIONS: This retrospective study demonstrated that overweight Hispanic adolescents with PCOS had more IR, IGT and DM than their non-PCOS counterparts. As the QUICKI Index was abnormal in all subjects with IGT and DM, we suggest its use as the first step in deciding which overweight Hispanic adolescents with PCOS should be further tested with an OGTT. Pediatrics 2009; 124: e496-e502

关键词： 多囊卵巢综合征   中医病因病机   综述  

摘要： 多囊卵巢综合征（PCOS）是妇科临床常见的内分泌失调性疾病。主要表现为月经失调、不孕、多毛、痤疮、肥胖等。目前本病的病因尚不清楚，自古至今的中医医家们虽然对多囊卵巢综合症的认识众说纷纭，各有侧重，但归结起来无非就是肾虚痰阻肝郁气滞、肾虚血淤等证型，本文从肾虚、肝郁气滞等证型方面综述了近年来多位医家对多囊卵巢综合症的中医病因病机研究，希望能为该病辨证论治的发展抛砖引玉。

关键词： 多囊卵巢综合症   不孕症   温肾豁痰   临床研究  

摘要： 目的:观察中药联合氯米芬+地塞米松治疗多囊卵巢综合征所致不孕的临床功效,初步评价其作用机理。方法:将门诊120例PCOS不孕患者随机分为试验组72例,予内服温肾豁痰中药联合氯米芬+地塞米松治疗,观察组48例单纯内服氯米芬+地塞米松治疗。1个月经周期为1个疗程,共治疗6个疗程。6个疗程后综合判定疗效,通过统计学方法处理。结果:妊娠率试验组为69.44%,对照组为39.58%;排卵率比较,试验组为86.81%,观察组为70.13%。两组治疗后妊娠率、排卵率比较有显著性差异(P<0.05)。结论:中药联合氯米芬+地塞米松治疗PCOS不孕疗效显著。