多囊卵巢综合征诊断标准的争议

Controversy in diagnostic criteria of polycystic ovarian syndrome

多囊卵巢综合征是常见的多样性表现的内分泌疾病,其病因仍不清楚,存在很大的争议。目前诊断标准仍不统一,其经历了从美国国立卫生研究院(NIH)诊断标准到鹿特丹诊断标准。目前,满足以下3个中的2个标准即可诊断为多囊卵巢综合征:①排卵过少或不排卵;②雄激素过多症的临床特征和生物化学的表现;③多囊卵巢。实际上,新标准扩大了诊断范围,增加了2个表型:①具有多囊卵巢和雄激素过多症排卵的女性;②具有多囊卵巢,但无雄激素过多而排卵过少的女性。尽管普遍认为增加这2个表型更能确定诊断,但其却带来了更多的负面影响,相关完善的研究仍需进行。

Polycystic ovary syndrome（PCOS） is a very common endocrinopathy with diverse presentations, its etiology is still uncertain and controversial. For diagnostic criteria of PCOS, there are National Institutes of Health （NIH） Criteria and Rotterdam Criteria till now. At present, Rotterdam Criteria is a newer diagnostic criteria and according to it, the diagnosis of PCOS could be determined if at least two of the following three features are met： ①Oligo-ovulafion or anovulation; ②Clinical and/or biochemical signs of hyperandrogenism; ③Polycystic ovaries. In fact, this new diagnostic criteria extend the definition of PCOS, adding two additional phenotypes of PCOS ： ①those women with polycystic ovaries, clinical and/or biochemical evidence of androgen excess, but without ovulatory dysfunction, and ②those women with polycystic ovaries and ovulatory dysfunction （oligovulation）, but without hyperandrogenemia and/or hirsutism. Although Rotterdam Criteria generally is considered that adding two additional phenotypes could make the diagnosis more precisely and easier than NIH Criteria, it brings more negative impacts and more related researches should be conducted further in the future.