卵巢性高雄激素血症的鉴别诊断

The differential diagnosis of hyperandrogenemia of ovarian source

本文的目的在于通过分析各种卵巢性高雄激素血症的睾酮水平和临床表现,为临床鉴别诊断提供参考。回顾性分析了1991年～2000年间因卵巢性高雄激素血症入院的睾酮>150mg/dl的32例患者的临床表现、诊断、治疗和预后。结果发现32例患者中睾酮<150ng/dl者19例,其中多囊卵巢患者15例,具分泌活性的卵巢肿瘤4例;肇酮>150ng/dl者13例,其中多囊卵巢者2例,具分泌活性的卵巢肿瘤11例,二组相比有明显差异(P<0.001)。喉结增大和阴蒂肥大在多囊卵巢组仅有1例,而卵巢分泌雄激素肿瘤组有6例,经卡方检验,具有显著的统计学差异。说明睾酮水平在150ng/dl以下大部分为多囊卵巢综合征,晕酮水平在150ng/dl以上多为具有分泌活性的卵巢肿瘤。

Objective To provide a simple method to make differential diagnose of hyperandrogenemia of ovarian source. Method A total of 32 cases with hyperandrogenemia of ovarian source were included and divided into PCOS (17 cases) and tumor group (15 cases) .Statistical method was used to analyxe the clinical manifestations, and serum testosterone level in each group.Results In PCOS group there were 15/17 cases with serum testosterone level less than 150ng/dl, while in tumor groug there were only 2/15 cases ( P < 0.001) , There were 1 and 6 cases of laryngeal prominence and enlarged clitoris in PCOS and tumor groups respectively.There was statistical difference between the 2 groups ( P < 0.05) . Conclusion Serum testosterone level of 150ng/dl may be a cutting level of polycystic ovarian syndrome and androgen secreting ovarian tumor in hyperandrogenemia.