多囊卵巢综合征诊断及治疗中的争议问题_刘嘉茵.pdf

国际生殖健康/ 计划生育杂志2011 年9 月第30 卷第5 期 J Int Reprod Health蛐Fam Plan ，September 2011, Vol. 30, No. 5 · · 343 多囊卵巢综合征研究进展重点专题 ·述评· 多囊卵巢综合征诊断和治疗中的争议问题 刘嘉茵 陈子江 【摘 要】 多囊卵巢综合征（PCOS）自1935年被首次描述以来，一直是生殖内分泌领域的热点问题。 因其高度的临床异质性和复杂的病因机制，PCOS的诊断和治疗长期存在争议。在国际各种诊断标准和治 疗共识的基础上，中华医学会妇产科分会妇科内分泌学组也发布了根据中国数据资料的PCOS的诊断标准 和治疗共识。但是在临床应用方面仍然存在一些争议和偏差。现对青春期PCOS的诊疗、PCOS的诊断标准 和分型、PCOS合并不孕的诊疗规范进行述评。提出了对青春期PCOS诊断的慎用和合理的处理原则；解读 了国内PCOS诊断标准的依据和按胰岛素抵抗程度分型的临床意义；强调了PCOS合并不孕的生活方式调 整和三线治疗的规范和流程。 【关键词】 多囊卵巢综合征；青春期；不育，女（雌）性；诊断；治疗 The Controversies on Evaluation and Management of Polycystic Ovary Syndrome LIU Jia-yin ，CHEN Zi- jiang. The First Affiliate d Hospital of Nanjing Medical University ，Nanjing 210029 ，China （LIU Jia-yin）； Provincial Hospital Affiliated to Shandong University ，Jinan 250021 ，China （CHEN Zi-jiang） 【Abstract 】 Polycystic ovary syndrome （PCOS）has been studied and discussed as one of the hottest topics for decades since it was firstly described in 1935. Evaluation and management of PCOS have been argued for long time because of its high heterogeneity and complex mechanism. Referring to various international diagnostic criteria and consensus of PCOS ，recently a new diagnostic criteria and consensus based on the data of Chinese population has been issued by Chinese Society of Obstetrics and Gynecology ， although there were still so many troubles and deviations in application. This review focused on the following topics ，pubertal PCOS ，diagnosis and typing of PCOS ，and the clinic pathway of management for PCOS with infertility. Three of the most popular problems on PCOS practices were reviewed as follows ：caution on the diagnosis and management for puberty girls with symptoms like P