多囊卵巢综合征病因、发病机制及治疗的最新研究进展

Research Progress in the Etiology, Pathogenesis and Treatment of Polycystic Ovary Syndrome

多囊卵巢综合征(PCOS)是一种育龄期妇女常见的内分泌紊乱疾病,除了本身固有的多囊样卵巢、高雄激素血症及排卵功能障碍的特征外,常伴有肥胖、2型糖尿病和血脂代谢异常等。随着生活环境的改变,PCOS发病率呈上升趋势。若PCOS病情长期得不到改善,不仅影响患者生殖健康,也影响患者全身健康。虽然对PCOS有了一定的了解,但是PCOS病因复杂、临床表现具有高度异质性,因此更加强调综合治疗。对于有生育需求的PCOS患者,应当在改变生活方式、控制体质量基础上,采用药物诱发排卵解决生育问题;而PCOS促排卵方案的目标是避免多卵泡发育,尽量获得单个卵泡发育;即使在体外受精(IVF)/胞浆内单精子注射(ICSI)中,也应避免过多卵泡发育,防止卵巢过度刺激综合征和多胎妊娠的发生。现就PCOS的病因、发病机制及治疗的研究进展进行综述。

Polycystic ovary syndrome(PCOS)is one of the common endocrine disorders in women of reproductive age.In addition to their inherent polycystic ovary,hyperandrogenism and ovarian dysfunction,there are obesity,type 2 diabetes,dyslipidemia and other metabolic abnormalities.With the change of living environment,the incidence of PCOS gradually increases.If the condition is not improved for a long time,it will not only affect reproductive health,but also affect general health.Although we have made a little progress in understanding PCOS,the complicated etiology and heterogeneous clinical manifestations suggested that the comprehensive treatment was very important for those PCOS women.For those PCOS women with fertility demand,the ovulation induced with drugs will help them to get pregnancy.However,the objective of the ovulation induction should be to get a single developed follicle,and to avoid the multiple developing follicles.In IVF/ICSI cycles,an excess of developing follicles should be avoided so as to prevent ovarian hyperstimulation syndrome(OHSS)and multiple pregnancy.The research progress of the etiology,pathogenesis and treatment of PCOS were briefly discussed in this review.