青春期多囊卵巢综合征的临床表现及诊治进展

Clinical manifestations,diagnosis and treatment of adolescent polycystic ovary syndrome

多囊卵巢综合征(PCOS)是一种影响女性终身的内分泌及代谢性疾病,发病机制尚不清楚。PCOS多起病于青春期,早期识别及干预可能降低相关并发症的风险,如代谢综合征(MS)、不孕症、2型糖尿病(T2DM)、心血管疾病、子宫内膜病变。青春期PCOS主要表现为月经不规律和生化/临床高雄激素血症(HA),如多毛症、痤疮,常伴肥胖、代谢紊乱以及情绪障碍。青春期PCOS的诊治应以临床表现为基础,避免过度诊断。一线治疗为生活方式调整,联合药物治疗可能是肥胖PCOS患者有效的治疗手段,对于PCOS高风险青春期女性应密切随访。具体治疗需根据临床表现和主诉,制定适合个体的治疗方案。

Polycystic ovary syndrome(PCOS)is an endocrine and metabolic disease affecting women's life,and its pathogenesis is not clear.Early onset of PCOS is associated with puberty.Early identification and intervention may reduce the risk of associated complications,such as metabolic syndrome(MS),infertility,type 2 diabetes mellitus(T2DM),cardiovascular disease,and endometrial lesions.Adolescent PCOS is mainly characterized by irregular menstruation and biochemical/clinical hyperandrogenemia(HA),such as hirsutism and acne,often accompanied by obesity,metabolic disorders and emotional disorders.The diagnosis and treatment of adolescent PCOS should be based on clinical manifestations and avoid over diagnosis.The first-line treatment is lifestyle adjustment.Combined drug therapy may be an effective treatment for obese patients with PCOS.Adolescents at high risk of PCOS should be closely followed up.Specific treatment needs to formulate a treatment plan suitable for individuals according to clinical manifestations and main complaints.