青春期多囊卵巢综合征肥胖与高雄激素临床表现的研究

摘要

Objective To review the clinical features of adolescent patients with polycystic ovary syndrome (PCOS). Methods Eighty eight adolescent patients with polycystic ovary syndrome (PCOS group), including 40 cases with insulin resis-tance(IR) and 48 cases without insulin resistance(non-IR), and 87 healthy subjects(control group) were enrol ed in the study. The body mass index (BMI), homeostasis model of assessment for insulin resistence index (HOMA-IR) was measured in al groups. Results The prevalence of hirsutism, acne and obesity was significantly higher in PCOS group than those in control group (P<0.01), and that in IR group was also higher than in non-IR group (P<0.01). Menstrual disorders including dysmenorrhea and oligomenorrhea were common in PCOS group. Conclusion The adolescent PCOS patients have higher incidence of obesity, which may affect the insulin resistance, so weight control is the basic treatment for those patients.%　　目的比较青春期多囊卵巢综合征（PCOS）患者与青春期健康对照人群、以及青春期PCOS患者中胰岛素抵抗（IR）与非IR的临床表现，以认识青春期PCOS的临床特征，为该疾病的早期诊断和治疗提供循证医学依据。方法青春期PCOS患者88例，健康对照组87例，并根据胰岛素抵抗稳态模型指数（HOMA-IR）将青春期PCOS患者分为IR组（40例）和非IR组（48例）。记录身高、体重、空腹血糖、空腹胰岛素、月经、多毛、痤疮等情况，并加以对照研究。结果青春期PCOS组月经均不规则，多毛、痤疮及肥胖发生率高，程度重。青春期PCOS IR组多毛、痤疮、高雄激素表现及肥胖发生率显著高于非IR组，肥胖PCOS患者IR发生率显著高于非肥胖PCOS。结论青春期PCOS患者肥胖发生率更高，肥胖放大了PCOS IR的程度和效应，控制体重为首选也是最基本的治疗方案。早期认识青春期PCOS的临床特征，有助于早期预测和诊断青春期PCOS及IR，并预防2型糖尿病、心血管疾病等远期并发症的发生。