关键词： fibrillin   fibrillin-3   folliculogenesis   polycystic ovary syndrome   ovary  

摘要： Polycystic ovary syndrome (PCOS) is a common endocrinopathy in women of reproductive age. Although genetic linkage analyses have demonstrated a susceptibility locus for PCOS mapping to the fibrillin-3 gene, the presence of fibrillin proteins in normal and polycystic ovaries has not been characterized. This study compared and contrasted fibrillin-1, -2, and -3 localization in normal and polycystic ovaries. Immunohistochemical stainings of ovaries from 21 controls and 9 patients with PCOS were performed. Fibrillin-1 was ubiquitous in ovarian connective tissue. Fibrillin-2 localized around antral follicles and in areas of folliculolysis. Fibrillin-3 was present in a restricted distribution within the specialized perifollicular stroma of follicles in morphological transition from primordial to primary type [transitional follicles (TFs)]. Fibrillin-1 and -2 stainings of PCOS ovaries were similar to those of the controls. However, in eight of the nine PCOS ovaries, there was a decrease in the number of TFs associated with fibrillin-3, including no staining in five PCOS samples;decreased number of fibrillin-3-associated TFs/mm(2) was confirmed by quantitative analysis. Our findings support a role for fibrillin-3 in the pathogenesis of PCOS and suggest fibrillin-3 may function in primordial to primary follicle transition. We propose that loss of fibrillin-3 during folliculogenesis may be an important factor in PCOS pathogenesis. (J Histochem Cytochem 58:903-915,2010)

关键词： 多囊卵巢综合症   中西医结合疗法   中医妇产科学  

摘要： 目的探讨中西医结合治疗多囊卵巢综合症。方法对42例多囊卵巢综合症患者进行中西医结合治疗，并对治疗结果进行评估。结果50例患者平均随访6～28个月（平均19个月），50例患者综合治疗均有效。

关键词： 多囊卵巢综合症   穴位埋线   妊娠率   自然流产  

摘要： 目的:探讨穴位埋线联合中西药物对PCOS患者排卵率、妊娠率及流产率的临床疗效。方法:采用随机数字表法将84例肥胖型PCOS患者随机分为两组,针药组42例予以穴位埋线联合加减少腹逐瘀汤及西药治疗,药物组42予以加减少腹逐瘀汤及西药治疗,观察两组患者3个月内的排卵率、妊娠率及流产率。结果:针药组共促排卵80个周期,28例妊娠,周期妊娠率35.0%,妊娠率66.7%,自然流产1例。药物组共促排卵86个周期,18例妊娠,周期妊娠率20.9%,妊娠率42.9%,自然流产2例。结论:穴位埋线联合中西药物治疗多囊卵巢导致的不孕不育有良好的疗效。

关键词： 多囊卵巢综合症   复方环丙孕酮   盐酸二甲双胍   马来酸罗格列酮  

摘要： 目的 探讨应用复方环丙孕酮分别与胰岛素增敏剂盐酸二甲双胍和马来酸罗格列酮治疗多囊卵巢综合症（PCOS）的临床效果.方法 选择在我院就诊的PCOS患者45例,随机分成两组,A组（复方环丙孕酮和盐酸二甲双弧）25例,B组（复方环丙孕酮和马来酸罗格列酮）20例,治疗疗程3个月经周期.比较两组患者用药前后体重、血糖及胰岛素水平、生殖激素水平变化及排卵和月经改善情况.结果 A组治疗后患者体重降低（P＜0.05）,两组治疗后体重比较,差异有统计学意义（P＜0.05）;两组患者空腹胰岛素、胰岛素抵抗指数等显著下降,B组治疗后数值低于A组（P＜0.05）;两组患者治疗后血清睾酮较治疗前明显降低,与治疗前相比,差异有高度统计学意义（P＜0.01）,但两者之间差异无统计学意义（P＞0.05）;两组患者治疗后排卵率比较,B组高于A组,差异有统计学意义（P＜0.05）.结论 应用复方环丙孕酮与胰岛素增敏剂治疗PCOS患者,可以明显改善患者的胰岛素抵抗、内分泌及代谢紊乱.盐酸二甲双胍有轻微降低体重的作用,价格便宜;马来酸罗格列酮减轻胰岛素抵抗及提高排卵率效果优于盐酸二甲双胍,但因用药安全性问题及价格较贵,仍以盐酸二甲双胍为一线用药.

关键词： 月经不调   生姜   身体   运动性闭经   女性健康   多囊卵巢综合症   红糖   活血化淤   促肾上腺皮质激素释放激素   睡眠质量  

摘要： 正月经不调慎喝红糖生姜水月经不调怎么办?民间流传喝红糖生姜水能调养。可专家指出,此法并不是万能的,甚至可能误事。小张26岁,月经一直不规律,但因为没有别的不适,她也没治疗过。今年她打算生孩子,想在怀孕前调养一下身体。医生问她平时如何应对经期,小张称,每次月经迟来或量少,她便按老人们说的,喝红糖生姜水,以活血化淤。

关键词： 多囊卵巢综合征   中药人工周期   月经失调  

摘要： 多囊卵巢综合征(PCOS)是一种育龄妇女多发的内分泌疾病之一,以闭经或月经稀发、不孕、肥胖、多毛和卵巢多囊性增大为临床特征。本文主要探讨中医对PCOS病机的认识,并结合诊断标准,透过对现代中西医进展的研究,使用中药进行辨证论治及人工周期治疗,逆转生殖内分泌紊乱状态。中药相对于西药治疗远期疗效显著、副作用小,有效减轻卵巢过度刺激等并发症,是颇有发展前景的治疗方法。

关键词： 卵巢过度刺激症   补肾法   多囊卵巢综合症   2009年   妊娠   治疗   西药   月经稀发  

摘要： 1病例讨论患者,30岁,月经稀发10年,诊断为多囊卵巢综合症,原发不孕。因“停经37d,下腹胀10d”于2009年8月5日入院,LMP:2009年6月30日。月经周期第7－11d开始每天服用克罗米芬100mg,B超监测卵泡未见发育,故予月经第14d起隔日肌注HMG150u,连用4次,月经周期第21d查B超提示:左侧卵巢优势卵泡3－4个,[第一段]

关键词： 多囊卵巢综合症   补肾调经育子汤   二甲双胍   中西医结合疗法  

摘要： 目的:观察补肾调经育子汤合西药治疗多囊卵巢综合征不孕的疗效。方法:将66例该病患者随机分为两组,治疗组36例予自拟补肾调经育子汤口服,同时加服二甲双胍薄膜片;对照组单服二甲双胍薄膜片。两组均3个月经周期为1个疗程。结果:治疗组排卵27例,排卵率为75.0%(95%CI=60.9%～89.1%);对照组排卵11例,排卵率为36.7%(95%CI=19.5%～53.9%);治疗组妊娠21例,妊娠率58.3%(95%CI=42.2%～74.4%);对照组妊娠7例,妊娠率23.3%(95%CI=8.2～38.4);两组排卵率(χ2=9.8442,P<0.01)、妊娠率(χ2=8.2066,P<0.01)比较,差异显著。结论:补肾调经育子汤配合二甲双胍薄膜片对多囊卵巢综合症所致不孕疗效优于单用二甲双胍薄膜片,其收益为OR=0.19(95%CI=0.07～0.56),NNT=3(95%CI=1.61～6.95);其收益为OR=0.22(95%CI=0.07～0.64),NNT=3(95%CI=1.70～9.05)。

关键词： 二甲双胍   吡格列酮   多囊卵巢综合症   :514357广东省丰顺县黄金卫生院  

摘要： 目的：探讨应用二甲双胍联合吡格列酮治疗多囊卵巢综合症的临床效果。方法：选择2006年8月～2008年10月确诊为多囊卵巢综合症的女性患者156例分为治疗组和对照组，每组各78例。对照组单用二甲双胍治疗；治疗组在对照组的基础上，加用吡格列酮治疗，均治疗6个周期。观察两组患者血清激素水平，空腹血糖及胰岛素水平，并应用经阴道B超检查卵巢的变化。结果：治疗后，两组患者血清LH、T、空腹血糖、空腹胰岛素及稳态模型的胰岛素抵抗指数均有不同程度的下降；两组患者双侧卵巢体积均缩小，卵泡数较前减少。上述各项指标治疗组改善较对照组更加明显。治疗组疗效优于对照组。结论：应用二甲双胍联舍吡格列酮治疗多囊卵巢综合症方法简单，疗效确切。

关键词： Spectra   HYPERANDROGENEMIA   Atherosclerosis   Arteriosclerosis   Prediabetic State   Insulin Resistance   Polycystic Ovary Syndrome   Acanthosis Nigricans   Female Adolescents  

摘要： Objective: Polycystic ovary syndrome (PCOS) in adult women is associated with increased risk of metabolic syndrome (MS) and atherosclerosis. We evaluated the spectrum of metabolic dysfunction in relationship with hyperandrogenemia (HA) in adolescent girls with PCOS. Materials and methods: Ovulatory function, acne, hirsutism (HS), body mass index (BMI), body composition, fasting lipids, glucose, insulin, free testosterone (FT), high-sensitivity C-reactive protein (hs-CRP), and HbA1c were evaluated in 103 girls. The homeostatic assessment model equations (HOMA-IR and HOMA-%B) were used for determination of insulin resistance and beta-cell function respectively. Results: The oligo-ovulation (Oligo) + HA + HS (n=44), Oligo + HA (n=28), and Oligo + HS (n=31) phenotypes had similar BMI. However, hyperandrogenemic phenotypes had higher prevalence of acanthosis nigricans (AN) and acne (P<0.01) and higher insulin, HOMA-IR, HOMA-%B, HbA1c, and hs-CRP levels than Oligo + HS group (P<0.01). Serum FT was correlated with HOMA-IR (r=0.38, P<0.01), HOMA-%B (r=0.49, P<0.01), hs-CRP (r=0.42, P<0.01), AN (r=0.39, P<0.01), and HbA1c (r=0.27, P<0.01). Furthermore, 34% of girls met diagnostic criteria for MS displaying higher BMI, FT, HOMA-%B, HOMA-IR, hs-CRP, and HbA1c than subjects without MS (P<0.01). Using combined HOMA-IR >= 4.0 and hs-CRP>3.0 cut-off values, 71.4% of MS versus 23.5% non-MS group were considered at risk of diabetes and atherosclerosis (P<0.0001). Conclusions: Hyperandrogenemic PCOS phenotypes have greatest degree of insulin resistance and inflammation. The use of insulin resistance and inflammatory markers may help identify adolescent girls with PCOS at risk of cardiometabolic syndrome.