关键词： Polycystic ovarian syndrome   metformin   ovarian volume   hyperandrogenism   SECRETION  

摘要： Background: It is well known that there is a close relationship between elevated androgen plasma levels and the ultrasound findings of stromal hypertrophy in polycystic ovary syndrome (PCOS). The objective of this study was to investigate the effects metformin on the hyperandrogenism and ovarian volume in PCOS. Methods: The study is an unrandomized clinical trial with before-after design. Twenty eight patients with infertility (male or female factor) meeting the Rotterdam ESHRE/ASRM criteria for PCOS were studied during the 2008-2009. The anthropometric characteristics of the patients, mean bilateral ovarian volume, and morphology by trans vaginal sonography as well as the plasma levels of leutinizing hormone, follicle stimulating hormone, estradiol, testosterone, 17-alpha-hydroxyprogesterone, and dehydroepianderosterone sulfate were obtained before and after treatment with metformin (500 mg three times a day) for three months. Paired t, Pearson's Correlation Coefficient, or Partial Correlation test was used to analyze the findings. Results: The patients had a mean age of 25.67 years. A significant reduction in mean ovarian volume (11.70 +/- 4.31 ml vs 8.27 +/- 3.71 ml P= 0.001), body mass index (BMI, 28.11 +/- 4.55 kg/m(2) vs 26.84 +/- 4.55 kg/m(2) P= 0.000) and serum androgen levels was seen after three months of treatment with metformin. There was positive correlations between the ovarian volume and serum testosterone level (r= 0.589, P= 0.001) or BMI (r= 0.663, P= 0.000). Conclusion: Metformin therapy may lead to a reduction in ovarian volume. It is likely that the reduction of ovarian volume reflect a decrease in the mass of androgen producing tissues.

关键词： SYNDROME PCOS   YOUNG-WOMEN   ENDOTHELIAL DYSFUNCTION   CARDIOVASCULAR-DISEASE   GENDER-DIFFERENCES   MENSTRUAL-CYCLE   REDUCED NUMBER   NONOBESE WOMEN   RISK-FACTORS   REDUCTION  

摘要： Objective: Subjects with Polycystic ovarian syndrome (PCOS) are at increased risk of Type 2 diabetes mellitus (T2DM). The mechanism of this enhanced risk is unclear. Circulating vascular progenitor cells (VPC) are immature bone marrow derived cells capable of differentiating into mature endothelial cells. VPC number/function and central arterial stiffness predict cardio-metabolic disease in at-risk populations. Design: We studied VPC and arterial stiffness measures in non-obese PCOS subjects as compared to age and body mass index (BMI) matched healthy controls in a cross-sectional study. Methods: Fourteen subjects with PCOS and 12 controls of similar age, BMI (all <30 kg/m(2)) and metabolic profile were studied. VPC number and in vitro function were studied by flow cytometry and tube formation assays respectively. Augmentation index (AIx), a measure of central arterial stiffness, and central (aortic) blood pressures (BP) were measured by applanation tonometry. Results: Subjects with PCOS had a reduced number, mean +/- SEM, of circulating CD34(+) 133(+) VPCs (317.5 +/- 51.0 vs. 558.3 +/- 101.2, p = 0.03) and impaired in vitro tube formation (completed tube area 1.0 +/- 0.06 vs. 1.2 +/- 0.05x10(6) mu m(2) p = 0.02). PCOS subjects had significantly higher AIx (18.4 +/- 1.9% vs. 4.9 +/- 2.0%) and this difference remained significant even after adjustments for age, BMI and smoking (p = 0.003) in multivariate analyses. Central systolic and pulse pressure were higher in PCOS subjects but these differences were not statistically significant after adjustment for age. Brachial systolic and pulse pressures were similar. VPC number/function and arterial stiffness or BP measures were not correlated. Conclusions: Non-obese PCOS is characterized by a reduced VPC number, impaired VPC function and increased central arterial stiffness. These changes in novel vascular risk markers may explain the enhanced risk of T2DM and CVD in PCOS.

关键词： PCOS   达英-35   性激素   治疗  

摘要： 笔者结合临床实际经验,分析了达英-35在治疗多囊卵巢综合症的有效疗法,并筛选了符合临床、生化及B超三项诊断标准者进行跟踪治疗,疗效显著。

关键词： 多囊卵巢综合症   胰岛素抵抗   高雄激素血症   甘油三脂  

摘要： 目的通过比较不同表型多囊卵巢综合征患者的代谢特征,寻找多囊卵巢综合征(PCOS)患者临床特点与代谢综合征及心血管疾病风险独立预测因子血脂、C-反应蛋白(CRP)之间的关系。方法依据2003年鹿特丹会议制定的诊断标准选择PCOS患者48例,依据患者的不同表型分为三组:高雄激素无排卵型、高雄激素有排卵型、非高雄激素无排卵型。比较不同表型多囊卵巢综合征患者胰岛素抵抗指数、肥胖发生率及血脂、CRP的差异。结果高雄激素无排卵型多囊卵巢综合征患者胰岛素抵抗率及肥胖发生率明显高于高雄激素有排卵型及非高雄激素无排卵型,差异均有统计学意义(χ2分别=4.49、3.88、5.34、6.44,P均<0.05);高雄激素无排卵型多囊卵巢综合征患者血清甘油三脂水平、低密度脂蛋白水平明显高于高雄激素有排卵型及非高雄激素无排卵型,差异均有统计学意义(t分别=2.17、2.39、2.23、2.13,P均<0.05)。高雄激素无排卵型多囊卵巢综合征患者血清C-反应蛋白水平明显高于高雄激素有排卵型,差异有统计学意义(t=2.30,P<0.05)。结论高雄激素无排卵型的PCOS患者将来更易发生代谢综合征,可能更易患心血管疾病。

关键词： 腹腔镜手术   多囊卵巢综合症  

摘要： 目的：探讨腹腔镜手术治疗多囊卵巢综合症（pcos）的临床效果.方法：我院于2003年7月-2008年7月间对pcos不孕患者78例行腹腔镜下卵巢打孔术,术中并行输卵管美兰通液检查,诊断pcos按国际鹿特丹标准[1]：①月经紊乱：稀发或闭经.②高雄激素：有临床高雄表现或和同时有生化检查标准,排除其它明确的高雄激素疾病.③B超：卵巢多囊,≥12个卵泡或体积＞10mil.观察术后,随访1个月,2个月,3个月,6个月,12个月内的排卵情况、受孕情况、流产情况及手术前后内分泌水平变化情况.结果：术后B超检测卵泡发育,排卵率即40﹪以上,并逐月递增,至术后6个月排卵率达89﹪以上;1个月内妊娠2例,3个月内妊娠20.5﹪之后也呈逐月递增,1年内妊娠84.61﹪;3个月内流产率6﹪6个月8.51﹪;术后血清黄体生成素（LH）和雄激素（T）水平较前明显下降,而卵泡生成素（FSH）和雌二醇（E2）变化水平不明显.结论：腹腔镜手术卵巢打孔是治疗pcos的有效方法,有利于诱发排卵,并获得妊娠,达到治疗目的.

关键词： polycystic ovary syndrome   phenotypes   cardiovascular disease risk   dyslipidemia   obesity   metabolic syndrome   IMPAIRED GLUCOSE-TOLERANCE   FATTY LIVER-DISEASE   INSULIN-RESISTANCE   ANDROGEN EXCESS   ENDOTHELIAL DYSFUNCTION   HYPERANDROGENIC WOMEN   ROTTERDAM CRITERIA   METABOLIC FEATURES   DIABETES-MELLITUS   PREVALENCE  

摘要： Polycystic ovary syndrome (PCOS) is a common disorder in women of reproductive age, affecting around 10% of them. Polycystic ovary syndrome is considered to be related to increased risk for type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). There are 2 definitions for PCOS: one adopted in 1990 (classical PCOS with phenotypes A and B) and the otherin 2003 (Rotterdam criteria with 4 phenotypes A to D). The latter is a wider definition including the 1990 phenotypes. There is mounting data suggesting that phenotypes C and D are not actually related to increased CVD risk, and thus screening for CVD risk factors of intervening for primary CVD prevention in young women is not cost-effective. There is an increasing number of suggestions to return to the 1990 criteria plus some metabolic parameters to identify real CVD risk in this population. However, such a strategy needs verification by large, prospective studies.

关键词： 输卵管阻塞   多囊卵巢综合症   热线电话   健康   博士   腹腔镜下   婚后   难题   治疗方法   习惯性流产  

摘要： 正有些健康烦恼,是否挥之不去?有些孕育难题,是否找不到答案?孙永生博士开通健康热线,随时为您答疑解惑。孙博士擅长运用中西医结合方法诊疗多囊卵巢综合症、输卵管阻塞、习惯性流产等女性不孕症。下面是他对几位患者难题的解答,希望对您有所帮助。患者:我婚后4年不孕,月经也不规律,有时三四个月来一次。

关键词： 多囊卵巢综合征   中药   克罗米芬  

摘要： 目的:讨论中西医结合治疗多囊卵巢综合征(PCOS)的的临床效果以及相关分析。方法:采用回顾性分析的方法,对2008年至2010年12月我院妇科门诊治疗的118例确诊为多多囊卵巢综合征的患者,首先在确诊后给予中药服用治疗3个月经周期然后停止服药治疗1个月,根据检查从第5个月经周期开始西药治疗,服用开克罗米芬(CC)以达到促进排卵,同时观察治疗前后的激素水平的变化以及卵泡的恢复情况。结果:经过服药治疗5个周期后性激素水平有所改变(P<0.051),双侧卵巢的体积有所减小,卵泡的数量也有所减少。结论:采用中西医联合治疗多囊卵巢综合征,能够促进性激素水平的改变,改变卵巢的形态提高排卵的几率,治疗效果值得推广。

关键词： 多囊卵巢综合症   内分泌变化   联合用药  

摘要： 目的通过观察多囊卵巢综合症患者的机体内分泌变化探讨治疗多囊卵巢综合症的有效方法。方法选择46例多囊卵巢综合症患者,给予克罗米芬联合二甲双胍治疗,3个周期后观察患者性激素水平、糖代谢水平、卵巢体积变化情况及临床常见症状改善情况。结果治疗后性激素水平与治疗前比较,有极显著性差异(P<0.01),糖代谢水平、卵巢体积、多毛、痤疮及月经不调症状与治疗前比较,有显著性差异(P<0.05)。结论在多囊卵巢综合症的治疗中观察内分泌变化情况,提示联合用药能更好的调节性激素分泌,改善糖代谢水平,缩小卵巢体积,改善临床症状,提高有效率。