癫痫妇女生殖内分泌状况调查及临床特征分析  

A survey on the clinical characteristics of reproductive endocrinology of women with epilepsy

作　　者：周珏倩[1] 周列民[1] 方子妍[1] 王倩[1] 陈柳静[1] 陈子怡[1] 陈树达[1] 杨丽白[1] 

机构地区：[1]中山大学第一附属医院神经内科,广州510080

出　　处：《中华神经科杂志》2011年第4期247-251,共5页Chinese Journal of Neurology

基　　金：广东省科技计划资助项目（2007B0315102004,2009B060700108）

摘　　要：目的 对育龄期癫痫妇女的生殖内分泌状况进行调查,并对生殖内分泌紊乱,尤其是多囊卵巢综合征（polycystic ovary syndrome,PCOS）患者的临床特征进行系统分析,便于发现问题,及时干预.方法 对139例育龄期女性癫痫患者进行人体测量学及体征评分、月经评估、性激素测定及盆腔超声检查,收集超重、中心性肥胖、月经稀发或闭经、黄体生成素（LH）/卵泡刺激素（FSH）、高雄激素血症、多囊卵巢（polycystic ovary,PCO）共6项指标,利用统计学方法 分析其生殖内分泌紊乱的特征.结果 139例育龄期女性癫痫患者年龄（22.5±7.0）岁,其中30岁以下的处于生殖能力高峰的育龄女性占84.89%;患者中PCOS患病率达12.75%,明显高于我国普通育龄女性PCOS患病率.诊断PCOS特异度高的指标分别为高雄激素血症（100%）、LH/FSH＞2（93%）、月经稀发或闭经（90%）;诊断灵敏度高的指标分别为PCO（92%）、月经稀发或闭经（85%）、高雄激素血症（54%）.LH[PCOS组（10.24±6.92）IU/L,非PCOS组（4.16±2.62）IU/L,t=-3.899]、LH/FSH值[PCOS组（2.20±1.16）,非PCOS组（0.87±0.56）,t=-4.240）和睾酮水平[PCOS组（1.07±0.35）ng/ml,非PCOS组（0.46±0.25）ng/ml,t=-4.918]在PCOS组和非PCOS组之间的差异具有统计学意义（P＜0.01）.结论 性激素指标是诊断PCOS的客观指标;应重视对女性癫痫患者进行身高、体重、腹围、月经史、卵巢B超等指标的监测.当患者存在可疑生殖内分泌紊乱的临床特征时,必须检查性激素,以便及时发现异常,早期干预.Objective To investigate the reproductive endocrine status of women with epilepsy at childbearing age and to systematically analyze the clinical features of reproductive endocrine disorders,especially polycystic ovarian syndrome （PCOS）,to facilitate early detection and timely intervention.Methods In this study,scoring of anthropometry and physical signs,menstrul assessment,examination of sex hormone and pelvic ultrasound in women with epilepsy at childbearing age were performed,and the data such as overweight,central obesity,oligo/amenorrhea,luteinizing hormone （LH）/follicule-stimulating hormone （FSH）,hyperandrogenism and polycystic ovary （PCO） were collected. The characteristics of their reproductive endocrine hormone disorders were analyzed statistically. Results The age of these patients was （22. 5 ± 7.0 ） years,and women younger than 30 years old and at their peak fertility accounted for 84. 89%. The prevalence rate of PCOS in women with epilepsy at childbearing age （12. 75% ） was significantly higher than that of ordinary women at childbearing age （7.2%） in China.Highly specific indicators for PCOS were hyperandrogenism （100%）,LH/FSH ＞ 2 （93%） and oligo/amenorrhea （90%）,whilst the highly sensitive indicators for PCOS were PCO （92%）, oligo/amenorrhea （85%） and hyperandrogenism （54%）. This study revealed statistically significant difference in LH,LH/FSH and testosterone （T） between PCOS group （LH： （10.24 ± 6.92） IU/L; LH/FSH;（2.20 ± 1.16）;T： （ 1.07 ± 0. 35） ng/ml） and non-PCOS group （ LH： （4. 16 ± 2.62 ） IU/L; LH/FSH：（ 0. 87 ± 0. 56 ）;T： （0. 46 ±0. 25） ng/ml,t = -3. 899,-4. 240 and -4. 918 respectively,all P ＜0. 01 ）. Conclusions Hormone indices are objective indicators for the diagnosis of PCOS. In clinical practice,attention should be paid to height,weight,abodominal circumference,menstrul history and ultrasound examination of the ovary in women with epilepsy.When reproductive endocrine hormone disord

关 键 词：癫痫 多囊卵巢综合征 睾酮 促黄体激素 卵泡刺激素 

分 类 号：R711.75[医药卫生—妇产科学]