新疆维、汉族青春期多囊卵巢综合征特点及治疗探讨

Approach the characteristics and treatments of the puberty polycystic ovary syndrome of the Uygurs and Hans in Xinjiang.

目的:研究新疆维、汉族青春期多囊卵巢综合征(PCOS)的临床特点及复方醋酸环丙孕酮治疗的临床疗效和安全性。方法:调查新疆94例(维族39例,汉族55例)青春期PCOS患者的临床特征并随访观察复方醋酸环丙孕酮治疗6个周期前后的临床特征、血清性激素水平、卵巢超声相的变化以及副反应。结果:(1)临床特征:青春期PCOS患者的初潮年龄与正常女性相同。主要症状为闭经、月经稀发及月经不规律等月经异常。维族患者出现闭经者较汉族多(P<0.05);体检发现多毛,维族患者体毛普遍较汉族多(P<0.05),维族LH/FSH>2者较汉族多;痤疮则表现为汉族多于维族(P<0.05)。月经周期维族较汉族长(P<0.05);(2)治疗后,61例PCOS患者恢复自然月经。多毛和痤疮评分明显下降(P<0.05)。血清各性激素水平,如雌二醇(E2)、黄体生成素(LH)、促卵泡素(FSH)、LH/FSH、睾酮(T)、硫酸脱氢表雄酮(DHEAS)、游离睾酮指数(FAI)均下降,差异有统计学意义(P<0.05),性激素结合球蛋白(SHBG)增加(P<0.05)。双侧卵巢体积及双侧卵泡数量减少(P<0.05)。副反应轻微。复方醋酸环丙孕酮对维、汉族青春期PCOS患者治疗效果无统计学差异。结论:新疆维、汉族青春期PCOS患者的临床表现有一定差异。复方醋酸环丙孕酮可改善青春期多囊卵巢综合征患者的高雄激素症状及内分泌状况,对恢复排卵有一定的疗效。

Objective：To investigate the clinical features of the puberty polycystic ovary syndrome（PCOS） between the Uygurs and Hans in Xinjiang,and study the efficacy and safety of compound cyproterone acetate in the treatment of the puberty PCOS. Methods： Ninty-four patients （ including the Uygurs 39 patients and Hans 55 patients） of puberty PCOS were examed and received compound cyproterone acetate for 6 cycles. Serum sex hormone, pelvic uhrasonog- raphy,the clinical features were evaluated before and after 6 cycles treatment. Results： （ 1 ） Compared with the normal women, there was no different in the menarche in the puberty PCOS patients, but the major criteria was different. Body-hair in the Uygurs was much more than that of Hans and acne was less than that of Hans. Menstrual cycle was longer than that of Hans. （2） Sixty one patients had regular menstruation during compound cyproterone acetate therapy. Hirsute and acne score decreased significantly （ P 〈 0. 05 ）. Serum estradiol （ E2 ）, luteinizing hormone （ LH ）, follicle stimulating hormone （ FSH ）, LH/FSH, testosterone （ T）, dehydroepiandrosterone （Ds） and free androgen index （ FAI ） decreased significantly （ P 〈 0. 05 ）, while sex hor-mone binding globin（SHBG） increased significantly（ P 〈 0.05 ）. Bilateral ovarian volumes as well as follicle numbers decreased significantly （P 〈 0.05 ）. Serum high density lipoprotein （HDL） increased significantly （ P 〈 0.05 ）, while serum total cholesterol （ TC ） decreased significantly（P 〈 0.05）. Conclusion： There are some differences in clinical features between the Uygurs and Hans in the puberty PCOS patients. Compound cyproterone acetate has antiandrogenic effects on adolescent PCOS patients and improve their edocrine and of ovulation. It is effective in treatment of adolescent girls with PCOS.