高雄与PCOS_培训课件.ppt

二甲双胍治疗PCOS降低雄激素 J Clin Endocrinol Metab. 2000 Jan;85(1):139-46. 二甲双胍改善青少年PCOS肾上腺功能亢进 RN=reference normal females Arslanian et al, J Clin Endocrinol Metab 2002; 87:1555–1559. 高雄在PCOS诊治具临床重要性 诊断高雄是PCOS的诊治核心 　 结语 2012.4.７广州 二甲双胍治疗PCOS的预测 J Clin Endocrinol Metab. 2000 Jan;85(1):139-46. 血浆雄烯二酮 基础的月经频率（周期/年） 空腹胰岛素水平 ，多毛不严重，可以有更高的活产率 SHBG PCOS促排卵治疗 睾酮 FSH FSH 卵巢打孔 克罗米酚 GnRH 芳香化酶抑制剂 胰岛素增敏剂，减重，锻炼，COC PCOS中卵巢电凝术后雄激素水平长期改善 以前 3个月 1年 3年 10年 10-18年 18年 以前 3个月 1年 3年 10年 10-18年 18年 Gj?nnaess H. Fertil Steril.?1998 ;69(4):697-701. 曲格列酮治疗后血清游离睾酮的平均变化 Azziz R, et al. J Clin Endocrinol Metab.?2001;86(4):1626-1632. 校正的平均变化值(pg/mL) P=0.04 P=0.01 P=0.0001 曲格列酮治疗后的排卵率 Azziz R et al, J Clin Endocrinol Metab. 2001;86: 1626–1632. 每个治疗组（观察/预期）的平均排卵数 PCOS患者中，治疗对于总睾酮，SHBG的影响 N Engl J Med. 2007 Feb 8;356(6):551-66. 与基线相比，p0.05 PCOS病态肥胖妇女在减肥术后高雄改善 Escobar-Morreale HF, et al. J Clin Endocrinol Metab. 2005;90(12):6364-9. 随访研究 * * background: Polycystic ovary syndrome (PCOS) is a heterogeneous disorder characterized by oligo- or anovulation (ANOV), biochemical or clinical manifestations of hyperandrogenemia (HA) and PCOs. Four phenotypes of PCOS exist [phenotype 1 (ANOV + HA + PCO), phenotype 2 (ANOV + HA), phenotype 3 (HA + PCO) and phenotype 4 (ANOV + PCO)] but the differences between them are not well studied. We compared markers of insulin resistance (IR) and endocrine characteristics between the different PCOS phenotypes * The sisters were grouped by phenotypes: PCOS [hyperandrogenemia (HA) with chronic oligoor amenorrhea, n 39], HA with regular menses (n 36), unaffected (UA; n122) * Dyslipidemia is a feature of polycystic ovary syndrome (PCOS), but its pathogenesis remains controversial.We performed this study of mothers of women with PCOS to test the hypothesis that dyslipidemia is a heritable trait in families of women with PCOS and to investigate the impact of age on reproductive and metabolic phenotypes. Fasting blood was obtained in 215 non-Hispanic white mothers of women with PCOS