青春期多囊卵巢综合征8例报告

Polycystic Ovary Syndrome in Adolescence (Report of 8 Cases)

目的探讨围青春发育期少女多囊卵巢综合征 (PCOS)的发病及特征。 方法分析儿科内分泌门诊中11～ 16岁青春发育期女孩PCOS之特征 ,测定促性腺激素、性激素、肾上腺皮质有关激素的水平 ,并行肾上腺、子宫、卵巢超声检查 ,肥胖者同时进行糖代谢实验检查。 结果 8例具有符合PCOS诊断的一种或几种依据 ,即黄体生成素(LH)高分泌 ,黄体生成素与卵泡刺激素比值 (LH/FSH)升高 ;高雄激素血症 :包括血睾酮 (T) ,或雄烯二酮 (△ 4A) ,或硫酸脱氢表雄酮 (DHEA -S)的升高 ;肥胖伴高胰岛素血症 ;1例同时并存非胰岛素依赖型糖尿病 (NIDDM )。 8例患儿皆有月经失调、多毛、痤疮 ,4例肥胖者示黑棘皮的临床特征。B超未见肾上腺异常 ,而双卵巢容积均有增大 ,且有多囊卵泡。 结论对青春发育期少女具月经异常、肥胖、黑棘皮伴高胰岛素血症和 /或高雄激素血症和其相应症状伴LH、LH/FSH比异常增高 ,皆应重视盆腔B超的影像学检查及其所示的特征改变 ,以防漏诊。

Objective Recognize the onset and features of polycystic ovary syndrome (PCOS) in perimenarcheal girls. Methods Investigate the clinical characteristics of PCOS in 11 ～ 16 year-old adolescent girls and measure their serum level of gonadotropin,sex hormones,and several adrenocortical hormones. Examine the adrenal glands,uterus and ovaries by sonography. Assay glucose metabolism in obese girls. Results Eight cases during the perimenarcheal period showed one or several abnormalities in the PCOS entity such as high basal luteinizing hormone (LH) value associated with a high follicle stimulating hormone (LH/FSH) ratio,hyperandrogenism with elevated serum testosterone(T),or androstenedione(△4A)or dehydroepiandrosterone sulphate(DHEA-S). Obese girls showed hyperinsulinemia. The 1st case suffered from non-insulin-dependent diabetes mellitus(NIDDM),These 8 patients presented irregular menses,hirsutism,acne or obesity with acanthosis nigricans. Sonography of the adrenals revealed no abnormality,but pelvic ultrasound showed bilateral enlarged ovaries with multiple small cysts. Conclusion When the perimenarcheal girls when exist the menstrual dysfunction,obesity,acanthosis nigrican associated with hyperinsulinemia and/or hyperandrogenaemia and clinical evidence plus a significantly elevated LH,LH/FSH ratio,pelvic sonograph examination should be performed to avoid the neglect of PCOS diagnosis.