多囊卵巢综合征子宫内膜胰岛素抵抗的研究进展

Research progress of endometrial insulin resistance in polycystic ovary syndrome

多囊卵巢综合征(PCOS)是一种育龄期女性常见的内分泌紊乱性疾病,多数患者伴有胰岛素抵抗(IR),部分PCOS患者有局部的子宫内膜IR,进而导致子宫内膜病变。中西医治疗对PCOS子宫内膜IR及其导致的子宫内膜病变的具体作用主要表现在改善子宫内膜容受性、抑制子宫内膜不典型增生、降低子宫内膜息肉发生率等方面。同时PCOS患者常出现妊娠率低、流产率高的情况,通过中西医治疗还可提高妊娠率、降低流产率。现代分子生物学分析药物作用机制主要是通过改善胞内磷脂酰肌醇激酶/蛋白激酶B(PI3K/Akt)信号通路、葡萄糖转运蛋白4和胰岛素受体底物的表达来改善子宫内膜IR。本文就目前PCOS子宫内膜IR的临床应用及药物作用分子机制的研究进展进行综述,以期为临床医师的诊治提供更多思路。

Polycystic ovary syndrome(PCOS)is a common endocrine disorder in women of childbearing age,most patients are accompanied by insulin resistance(IR),some PCOS patients have local endometrial IR,which leads to endometrium lesions.The specific effects of traditional Chinese and Western medicine on PCOS endometrial IR and its resulting endometrial lesions are mainly manifested in improving endometrial receptivity,inhibiting endometrial dysplasy,and reducing the incidence of endometrial polyps.At the same time,PCOS patients often have low pregnancy rate and high abortion rate,and treatment with traditional Chinese and Western medicine can also improve pregnancy rate and reduce abortion rate.Modern molecular biology analysis of the drug action mechanism is mainly through improving the intracellular phosphatidylinositol kinase/protein kinase B(PI3K/Akt)signaling pathway,glucose transporter 4 and insulin receptor substrate expression to improve the endometrium IR.In this paper,the current clinical application of PCOS endometrial IR and the research progress of the molecular mechanism of drug action are reviewed in order to provide more ideas for the diagnosis and treatment of clinicians.