和代谢异常相关异子宫出血.pptVIP

胰岛素抵抗的治疗 加强体育锻练 改善饮食结构 药物治疗 噻唑烷二酮药物 如罗格列酮、吡格列酮 子宫内膜癌 妇科恶性肿瘤保留生育功能临床诊治指南 保留生育功能的治疗 1.大剂量高效孕激素治疗 2.其他方法：GnRH-i ；左炔诺孕酮宫内释放系统（LNG4US） 3.合并症的全身综合治疗：减肥，降脂，诊断和治疗糖尿病 I型子宫内膜癌预防 二甲双胍改善胰岛素抵抗，积极治疗子宫内膜病变 胡赛男，丰有吉 糖代谢异常与子宫内膜癌关系的研究进展 国际妇产科杂志2014年4月 1.激素避孕药（HCs） 2.生活方式调整 饮食控制 增加运动 减轻体重 3.二甲双胍 4.胰岛素增敏剂 肌醇和噻唑烷二酮 多囊卵巢综合征治疗 对于月经紊乱多毛痤疮 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