下丘脑-垂体-肾上腺轴和下丘脑-垂体-卵巢轴在多囊卵巢综合征神经内分泌功能紊乱中的作用  

Roles of Hypothalamic-Pituitary-Adrenal Axis and Hypothalamus-Pituitary-Ovary Axis in the Abnormal Endocrine Functions in Patients with Polycystic Ovary Syndrome

作　　者：王凡[1] 张正红[1] 肖开转[1] 王正朝[1] 

机构地区：[1]福建师范大学生命科学学院福建省发育与神经生物学重点实验室,福州350007

出　　处：《中国医学科学院学报》2017年第5期705-710,共6页Acta Academiae Medicinae Sinicae

基　　金：国家自然科学基金(31271255);福建省自然科学基金(2016J01145);福建省教育厅科技项目(JAT160118)~~

摘　　要：多囊卵巢综合征是一种常发生在妇女育龄时期的生殖性内分泌疾病,受多种因素影响,其病理生理学机制至今尚未明确;主要临床特征为无排卵、高雄激素血症、高胰岛素血症等,与神经内分泌系统异常密切相关。下丘脑-垂体-性腺轴在哺乳动物各种生命活动中发挥至关重要的调节作用,其中下丘脑-垂体-肾上腺轴(HPA)和下丘脑-垂体-卵巢轴(HPO)内分泌系统功能在多囊卵巢综合征中也存在异常,如促性腺激素释放激素脉冲频率异常、黄体生成素/卵泡刺激素比率升高、肾上腺源与卵巢源的雄激素过分泌等。同时,胰岛素和瘦素在多囊卵巢综合征内分泌功能紊乱也起一定作用。本文系统分析和总结了HPA和HPO轴在多囊卵巢综合征神经内分泌功能紊乱中的作用。Polycystic ovary syndrome( PCOS) is a common reproductive endocrine disease in women of childbearing age. While it can be affected by a variety of factors,its pathophysiology remains unclear. Its clinical features mainly include anovulation, hyperandrogenism, and hyperinsulinemia, which are closely related with abnormal neuroendocrine system. Hypothalamic-pituitary-gonadal axis( HPG) plays a crucial regulatory role in various life activities in mammals. In particular,hypothalamic-pituitary-adrenal( HPA) axis and hypothalamus-pituitary-ovary( HPO) axis can be abnormal in PCOS patients. The corresponding abnormalities include abnormal gonadotropin releasing hormone pulse frequency,increased luteinizing hormone/follicle-stimulating hormone ratio,and excessive excretion of adrenal and ovarian androgens. Meanwhile,insulin and leptin also play key roles in endocrine dysfunction in PCOS patients. This article systematically reviews the role of HPA axis andHPO axis in the neuroendocrine dysfunction in PCOS patients.

关 键 词：多囊卵巢综合征 下丘脑-垂体-肾上腺轴 下丘脑-垂体-卵巢轴 内分泌功能 

分 类 号：R711.75[医药卫生—妇产科学]