青春期多囊卵巢综合征的临床研究

A Clinical Study of Polycystic Ovarian Syndrome in Adolescents

目的:探讨青春期多囊卵巢综合征(PCOS)的内分泌代谢特点及处理。方法:35例患者按体重指数(BMI)<25、25～29和>29分成3组,10例正常同龄少女为对照组。用放射免疫法测定促卵泡生成激素(FSH)、促黄体生成激素(LH)、雌二醇(E2)、睾酮(T)、孕酮(P)、糖耐量试验(OGTT)、观察血糖(SG)、血胰岛素(INS)水平,测腰/臀比值(WHR)。对部分患者用二甲双胍250mg每日3次治疗8周后,复查OGTT及体重。结果:患者T、INS、P高于对照组,E2与对照组无明显差别都处在较低水平。LH/FSH高于对照者,但LH/FSH>2.5者仅5例,WHR>0.8达60％(21/35)。治疗后INS水平及体重下降。结论:青春期PCOS表现有三高一低(T、INS、P增高,E2相对不足),及LH/FSH增高不如成年患者明显。纠正高INS及胰岛素抵抗(IR)是恢复月经周期的关键。

Objective: To investigate the endocrine-metabolic characteristics and treatment of polycystic ovarian syndrome (FCX)S) in adolescents. Methods: Thirty-five adolescent girls with PCOS were divided into three groups based on BMI, <25,25-29,and>29. Ten healthy girls served as control. Basal serum follicle stimulating hormone (FSH), Luteinizing hormone (LH), Estradio (E2), Testosterone (T), and progesterone (P) were determined. Oral glucose tolerance test (OGTT), serum glucose (SG), and insulin (INS) were performed, and waist/hip ratio (WHR) and body weight were measured before and after oral administration of metformin 250 mg tid for 8 weeks. Results: PCOS patients had significantly higher T, INS, and P compared with the control, ? levels were all in a relatively lower level and similar to that of the control. LH/ FSH was higher than that in control group, but LH/FSH>25 was found in only 5 cases. INS level and body weight dropped after treatment. Conclusion: Adolescent girls with PCOS were characterized by higher levels of T, INS, P, and insufficient E2 . Elevated LH/FSH was not as typical as that of adult cases. Correcting hyperinsulinemia or insulin resistance may play a critical role in resuming menstrual cycle.