特发性卵巢早衰的临床研究

Clinical Research of Idiopathic Premature Ovarian Failure

目的探讨特发性卵巢早衰（卵巢早衰）的临床特征。方法选择2010年1月至2013年12月武汉大学人民医院生殖医学中心收治的39例卵巢早衰患者为观察组,选择同期因男方因素或输卵管因素不孕就诊的52例女性作为对照组,对两组临床资料及实验室检测结果进行分析。结果39例患者逐渐发展为持续性闭经。患者均存在不同程度的性器官萎缩。卵巢早衰患者临床表现为雌激素水平偏低,而促卵泡激素（FSH）、黄体生成素（LH）水平偏高。观察组雌激素水平显著低于对照组,FSH、LH水平则显著高于对照组（均P〈0.01）。卵巢早衰患者临床特征表现为性器官萎缩。39例卵巢早衰患者中,13~20岁的发病率居高;最长停经时间为1年之内的卵巢早衰患者发病率最高（59.0%）;初潮距发病时间以1~5年居多（41.0%）。疗程结束后卵巢早衰患者均能正常来月经,且雌激素水平偏低、FSH、LH水平偏高症状均呈现一定程度的缓解。39例卵巢早衰患者停药3个月后门诊随访显示,患者卵巢早衰症状复现。39例患者治疗后自然妊娠率为5.1%。结论月经紊乱、月经稀发女性应尽早进行阴道超声检测,同时检测血清性激素水平,以尽早确认是否存在卵巢早衰,以便尽早治疗。

Objective To study the clinical characteristics of idiopathic premature ovarian failure （ POF） .Methods A total of 39 patients with idiopathic POF from Reproductive Medicine Center of the People′s Hospital of Wuhan University during Jan.2010 and Dec.2013 were included as the observation group, and another 52 women with infertility due to either male factor or female fallopian tube factor during the same period were included as the control group , the clinical data and laboratory test results of the two groups were analyzed.Results Thirty-nine patients developed into persistent amenorrhea ,which all had dif-ferent degrees of genitals atrophy.The clinical manifestations of idiopathic POF were low estrogen level and high FSH, LH level.Estrogen level in the observation group was obviously lower than the control group , while FSH and LH levels were significantly higher than the control group （ all P 〈0.01 ） .Idiopathic POF patients′clinical manifestation was sex organ atrophy.Among the 39 patients with idiopathic POF, the patients aged 13-20 years had high incidence;patients with 1 year as the longest amenorrhea had the highest incidence of POF（59.0%）.The onset of POF was mostly 1 to 5 years after menarche（41.0%）.All of th POF patients after completion of treatment course had normal menstruation , and the low estrogen level and high FSH, LH levels were relieved to a certain degree.3 months after the administration of medication,the POF symptom of all 39 patients recurred.The natural pregnancy rate was 5.1% among the 39 patients after treatment.Conclusion Female with menstrual disorders, rare menstruation should have vaginal ultrasound tests as early as possible,and serum sex hormone levels detection should be tested at the same time ,to con-firm whether there is POF as soon as possible,to receive early treatment.