育龄期肥胖女性生殖功能与多囊卵巢综合征的关系及治疗的-海南医学.pdfVIP

Hainan Med J, Oct. 2015, Vol. 26, No. 20 海南医学2015年10月第26卷第20期 doi:10.3969/j.issn.1003-6350.2015.20.1105 ·综 述· 育龄期肥胖女性生殖功能 与多囊卵巢综合征的关系及治疗的研究进展 季海波，王卓然 (哈尔滨医科大学附属第一医院生殖科，黑龙江 哈尔滨 150001) 【摘要】 肥胖与育龄期妇女生育能力的关系极为密切，尤其是以腹型肥胖者更加明显，此类人群多表现为 月经稀发、雄激素水平增高及排卵障碍。此外，研究表明肥胖人群较正常人群更易发生多囊卵巢综合征、高雄激 素血症和代谢功能异常。基础性激素水平紊乱可能是导致不同类型肥胖的关键因素之一，并且在大量研究中已 证实降低体重可纠正性激素紊乱状态，降低雄激素水平，建立规律月经周期，恢复排卵，进而提高肥胖女性生育 能力。以往针对此情况多采用二甲双胍等药物，通过改善胰岛素抵抗等途径增强卵巢功能，提供生育能力。近 年来减肥药物因其具有减脂、改善胰岛素抵抗等作用，被用于此类患者的治疗，本文则对近年来多囊卵巢综合征 与育龄期肥胖妇女生育能力及相关药物治疗进行综述。 【关键词】 肥胖；卵巢功能；不孕症；减重；奥利司他 【中图分类号】 R711.75 【文献标识码】A 【文章编号】 1003—6350（2015 ）20—3041—05 Researchprogressintherelationshipbetweenpolycysticovarysyndromeandreproductivefunctioninobese womenofchild-bearingageandthetherapies.JIHai-bo,WANGZhuo-ran.DepartmentofReproductiveMedicine, theFirstAffiliatedHospitalofHarbinMedicalUniversity,Harbin150001,Heilongjiang,CHINA 【Abstract】 The relationship between obesity and fertility in women of childbearing age is very close, especial- ly abdominal obesity. Females with obesity often show oligomenorrhea, increased androgen levels and ovulation obsta- cle. In addition, studies show that obese people are more likely to have polycystic ovary syndrome, hyperandrogen- emia and metabolic abnormalities, compared with normal people. Disorder in sex hormones levels may be one of the key factors causing obesity of different types. Studies have confirmed that reducing of weight can correct sex hormone disorder, reduce androgen levels, establish regular menstrual cycle and restore ovulation, and thus improve the fertility of obese females. Previous experience applied drugs such as metfor