沂南县区及周边县区多囊卵巢综合症患者临床指标分析

CLINICAL ANALYSIS OF RELATED FACTORS OF POLYCYSTIC OVARY SYNDROME IN YI'NAN COUNTY AND ITS ADJACENT COUNTIES

目的探讨沂南县区及周边县区多囊卵巢综合症患者临床患病率及其相关因素。方法随机调查病例1500例,筛选出疑似PCOS患者205例,通过鹿特丹诊断标准确诊PCOS患者98例并随机抽取健康人群103例为对照组,并分析两组月经周期、不孕年限、睾酮、F-G评分、痤疮、性腺激素水平、糖脂代谢等临床指标。结果 98例PCOS患者中出现月经异常85例,占86.7%;98例PCOS患者高雄患病率38.7%(38/98),其中生化高雄占23.5%(23/98);98例PCOS患者PCOS患者卵巢多囊样表现突出,出现卵巢呈PCO表现者有94例,发生率为95.6%;PCOS组BMI、WHR、空腹血糖、空腹胰岛素、餐后血糖、餐后胰岛素、TG、TC、LDC-C均高于对照组,P<0.01;PCOS组HDL-C低于对照组,P<0.05。结论沂南县区及周边县区育龄期妇女PCOS的患病率为6.53%;沂南县区及周边城区育龄期妇女PCOS患者的临床表现以卵巢呈多囊性改变和月经异常为主,高雄激素发生率低,肥胖、多毛及痊疮表现不严重。ESHRE/ASRM诊断标准基本适合沂南县区及周边县区PCOS患者的诊断;肥胖是PCOS患者的高危风险因素;控制体重、改善环境心理压力,及精神心理疏导可预防PCOS患者进行性发展。

Objective To explore the morbidity rate of polycystic ovary syndrome（PCOS）and its related factors in Yi＇nan county and its adjacent counties.Methods 1500 cases were randomly surveyed and 205 cases were screened as cases of suspect PCOS.According to the Rotterdam diagnostic criteria,98 cases were confirmed.103 healthy cases formed the contrast group.Bot groups underwent the detection of menstrual cycle,infertility period,the level of testosterone,F-G scores,acne,the level of sex hormones and the level of glycolipid metabolism.Results Menstrual disorder occurred in 85cases（86.7%）of PCOS.Excessive androgen occurred in 38cases（38.7%）,and biochemical excessive androgen occurred in 23cases（23.5%）.94cases（95.6%）showed polycystic ovary.The levels of BMI,WHR,fasting blood-glucose,fasting insulin,postprandial blood glucose,postprandial insulin,TG,TC and LDC-C in the PCOS group were found higher than those in the contrast group（P 〈0.01）,and the level of HDL-C in the PCOS group was lower that in the contrast group（P 〈0.05）.Conclusion The morbidity rate of PCOS in women of childbearing period in Yi＇nan county and its adjacent counties is 6.53%.The clinical manifestations are mainly polycystic ovary and menstrual disorder.The occurrence rate of excessive androgen is low,and obesity,polytrichia and acne are not serious.ESHRE/ASRM diagnostic criteria is generally fit for the diagnosis of PCOS.Obesity is a high-risk factor of PCOS.Weight control,releasing mental stress and psychological counseling can help to prevent the progressive development of PCOS.