与代谢异常相关的异子宫出血修改版.pptx

与代谢异常相关的异子宫出血修改版

代谢紊乱

就是身体得一种状态

就是机体对物质得消化、吸收、排泄出现病理性、不协调

得供需不平衡得状态

可以表现为一种物质也可以表现为多种物质得紊乱

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

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什么就是胰岛素抵抗与高胰岛素血症？

胰岛素抵抗就是指各种原因使胰岛素促进葡萄糖摄取和利用得效率下降,机体代偿性得分泌过多胰岛素产生高胰岛素血症,以维持血糖得稳定。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得胰岛素抵抗指数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≥85pmol/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得诊断标准:

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项组中得3项或全部者可确诊为代谢综合征。

异常子宫出血(AUB)

月经出血超过正常得频率、规律性、持续时间与出血量称为异常子宫出血(即月经失调)

FIGOAUB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(Ovulatorydysfunction)

子宫肌瘤(Leiomyoma)

粘膜下(SM)

其她部位(O)

子宫内膜局部异常(Endometrial)

恶变和不典型增生(Malignancyandhyperplasia)

医源性(Latrogenic)

未分类(Notyetclassified)

研究表明与代谢异常相关得妇科疾病

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？

大家学习辛苦了，还是要坚持

继续保持安静

多囊卵巢综合症(PCOS)与代谢异常

糖代谢异常主要为胰岛素抵抗(IR)及高胰岛素血症

Burghen等(1980年)首次提出IR参与PCOS得病理过程

近期研究方向:

胰岛素受体基因及胰岛素信号传导途径得异常与PCOS及胰岛素抵抗有关

脂代谢异常

血脂改变主要有甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白-胆固醇(LDL-C)