多囊卵巢综合征合并代谢综合征患者的临床及生化特征  

Clinical and biochemical characteristics of patients with polycystic ovary syndrome and metabolic syndrome

作　　者：高金金[1] 侯丽辉[2] 李妍[2] 李艳秋[1] 

机构地区：[1]黑龙江中医药大学,黑龙江哈尔滨150040 [2]黑龙江中医药大学附属第一医院妇产科,黑龙江哈尔滨150040

出　　处：《中国医药导报》2016年第18期105-108,121,共5页China Medical Herald

基　　金：国家中医药管理局国家中医临床研究基地业务建设科研专项课题(JDZX2012039);侯丽辉全国名老中医药专家传承工作室

摘　　要：目的分析多囊卵巢综合征（PCOS）合并代谢综合征患者的临床及生化特征。方法选择临床科研信息一体化平台采集的2015年1～12月就诊于黑龙江中医药大学附属第一医院妇科门诊的138例PCOS患者的病历资料,其中PCOS合并代谢综合征（MS）者（A组）50例,无MS的肥胖型PCOS者46例（B组）,无MS的非肥胖型PCOS者（C组）42例。分析比较各组的一般临床特征、性激素水平、糖脂代谢水平。结果 A组患者体重、体重指数、腰围、臀围、腰臀比、收缩压、舒张压和黑棘皮发生率明显高于C组,差异均有高度统计学意义（P〈0.01）;A组黄体生成素低于C组,差异有统计学意义（P〈0.05）;A组性激素结合球蛋白明显低于C组,差异有高度统计学意义（P〈0.01）;A、B两组以上各项一般临床特征指标及性激素水平比较,差异均无统计学意义（P〉0.05）;A组空腹血糖（FPG）、空腹胰岛素（FINS）、稳态模型胰岛素抵抗指数（HOMA-IR）、总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、载脂蛋白B（apo B）、apo B/载脂蛋白A1（apo A1）明显高于C组,高密度脂蛋白胆固醇（HDL-C）、apo A1明显低于C组,差异均有高度统计学意义（P〈0.01）。A、B两组FPG、HOMA-IR比较,差异均无统计学意义（P〉0.05）,A组FINS、TC、TG、LDL-C、apo B、apo B/apo A1明显高于B组,HDL-C、apo A1明显低于B组,差异均有统计学意义（P〈0.05）。结论肥胖型PCOS患者与PCOS合并MS患者具有相似的一般临床特征、性激素水平、FPG水平和HOMA-IR,要重视对肥胖型PCOS患者进行MS的筛查。Objective To discuss the clinical and biochemical features of patients with polycystic ovary syndrome（PCOS）and metabolic syndrome（MS）. Methods From January to December 2015, 138 patients with PCOS in the Department of Gynecology of the No.1 Affiliated Hospital of Heilongjiang University of Chinese Medicine were collected by clinical research information integration platform. Patients with PCOS and MS were selected as group A（n = 50）, patients with obese PCOS but without MS were selected as group B（n = 46）, non-obese PCOS without MS were selected as group C（n = 42）. Characteristics and related influencing factors of each group were analyzed and compared. Results The levels of weight, BMI, waist size, hip circumference, WHR, blood pressure and the incidence of the black spine were significantly higher in group A than those in group C（P〈 0.05）. The levels of LH, SHBG in the group A were significantly lower than those of the group C（P〈 0.05）. There were no significant differences in above indexes of clinical features and sex hormones between group A and B（P〈 0.05）.The levels of FPG, FINS, HOMA-IR, TC, TG, LDL-C,apo B, apo B/apo A1 of the group A were significantly higher than those of the group C（P〈 0.05）; HDL-C,apo A1 of the group A were significantly lower than those of the group C（P〈 0.01）. The levels of FINS, TC, TG, LDL-C, apo B, apo B/apo A1 of the group A were significantly higher than those of the group B, but had no statistically significant difference in FPG, HOMA-IR between group A and B（P〉 0.05）. HDL-C and apo A1 of the group A were significantly lower than those of the group B（P〈 0.05）. Conclusion Patients with obese PCOS has the same clinical characteristics, sex hormone index, FPG and HOMA-IR with patients with PCOS and MS. It is important to focus on screening for MS in patients with obese PCOS.

关 键 词：多囊卵巢综合征 代谢综合征 临床特征 生化特征 

分 类 号：R711.75[医药卫生—妇产科学]