与代谢异常相关的异子宫出血2015-7-25 修改版.pptVIP

代谢紊乱与异常子宫出血 ````````````````````````````````````````````````````````````` ````````````````````````````````````````````````````````` 主要内容 代谢异常的相关概念 01 胰岛素抵抗病因及相关疾病预防治疗 03 与胰岛素抵抗有关的异常子宫出血及相关研究 02 代谢紊乱 是身体的一种状态 是机体对物质的消化、吸收、排泄出现病理性、不协调 的供需不平衡的状态 可以表现为一种物质也可以表现为多种物质的紊乱 代谢紊乱类型 营养物质代谢紊乱：糖紊乱，脂肪紊乱，蛋白质代谢紊乱 代谢产物代谢紊乱：尿酸代谢紊乱 电解质代谢紊乱：高钾、 低钾，高氯、低氯 糖代谢紊乱： 高血糖症与糖尿病 低血糖症 酮症 半乳糖血症 ``````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````````` 什么是胰岛素抵抗与高胰岛素血症？ 胰岛素抵抗是指各种原因使胰岛素促进葡萄糖摄取和利用的效率下降，机体代偿性的分泌过多胰岛素产生高胰岛素血症，以维持血糖的稳定。胰岛素抵抗易导致代谢综合征和2型糖尿病 全国糖尿病防治组测算的胰岛素抵抗指数HOMA-IR2.69判定为胰岛素抵抗（HOMA-IR=空腹胰岛素×空腹血糖／22.5） 高胰岛素血症：空腹胰岛素≥85 pmol/L=12.2pmol/L 胰岛素 1pmol/L=1mIU/L×6.965 代谢综合征诊断标准 中华医学会糖尿病学分会建议的诊断标准： 1.超重和（或）肥胖BMI≥25。 2.高血糖：空腹血糖（FPG）≥6.1mmol/L（110mg/dl）和（或）2hPG≥7.8mmol/L（140mg/dl），和（或）已确诊糖尿病并治疗者。 3.高血压：收缩压/舒张压≥140/90mmHg，和（或）已确诊高血压并治疗者。 4.血脂紊乱：空腹血甘油三酯≥1.7mmol/L（150mg/dl），和（或）空腹血HDL-C0.9mmol/L（35mg/dl）（男），1.0mmol/L（39mg/dl）（女）。 具备以上4项组中的3项或全部者可确诊为代谢综合征。 异常子宫出血（AUB） 月经出血超过正常的频率、规律性、持续时间与出血量称为异常子宫出血（即月经失调） FIGO AUB病因PALM—COEIN系统 PALM COEIN 息肉（Polyp） 全身凝血相关疾病 （Coagulopathy） 子宫腺肌症（Adenomyosis） 排卵障碍（Ovulatory dysfunction） 子宫肌瘤（Leiomyoma） 粘膜下（SM） 其他部位（O） 子宫内膜局部异常（Endometrial） 恶变和不典型增生（Malignancy and hyperplasia） 医源性（Latrogenic） 未分类（Not yet classified） 研究表明与代谢异常相关的妇科疾病 多囊卵巢综合症 已明确为代谢紊乱性疾病 子宫内膜癌 子宫内膜增生 子宫内膜息肉？ 多囊卵巢综合症（PCOS）与代