多囊卵巢综合征与复发性流产的研究进展

摘要

复发性流产(RSA)的发生与多种因素相关,包括年龄、遗传、内分泌与代谢障碍、免疫因素、子宫发育异常、血栓形成倾向、感染、精液质量和生活方式等.多囊卵巢综合征(PCOS)是一种以持续性无排卵、多卵泡不成熟、雄激素水平升高和胰岛素抵抗为主要特征的生殖功能障碍与糖代谢异常并存的内分泌紊乱综合征.PCOS患者RSA的发生率明显高于普通人群,30%~40%的PCOS患者存在自然流产史.目前,PCOS患者易发生RSA的具体发病机制尚不明确,可能与高黄体生成素血症、高雄激素血症、胰岛素抵抗、肥胖、高泌乳素血症、黄体功能不全、血栓形成等有关.本文从上述方面对PCOS患者发生RSA的常见原因及其预防进行综述.%Recurrent spontaneous abortion (RSA) is related with multi-factors including age,genetics,endocrine and metabolic disorders,immune factor,uterine dysplasia,thrombosis tendencies,infection,semen quality and lifestyle etc.Polycystic ovary syndrome (PCOS) is a kind of reproductive dysfunction and abnormal glucose metabolism of endocrine disorder syndrome,of which characteristic is sustainability anovulation,more immature follicles,elevated androgen level and insulin resistance.The incidence of recurrent miscarriage in PCOS patients is significantly higher than the general population.About 30% to 40% of PCOS patients have a history of spontaneous abortion.Currently the specific pathogenesis is unknown.It may be related to high LH,hyperandrogenism,insulin resistance,obesity,high PRL,luteal insufficiency and thrombosis.This paper reviews the common causes and prevention of RSA in PCOS patients.