多囊卵巢综合征患者脾虚证与内分泌代谢异常相关性研究  

Relation Between Spleen-Deficiency-Syndrome and Metabolic Abnormalities in Patients with Polycystic Ovary Syndrome

作　　者：王颖 侯丽辉 匡洪影 WANG Ying;HOU Lihui;KUANG Hongying(First Affiliated Hospital,Heilongjiang University of ChineseMedicine,Harbin 150040,Heilongjiang,China)

机构地区：[1]黑龙江中医药大学附属第一医院

出　　处：《辽宁中医药大学学报》2019年第8期114-117,共4页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：黑龙江省普通高校青年创新人才培养计划项目(UNPYSCT-2018227)

摘　　要：目的:探讨多囊卵巢综合征(PCOS)患者脾虚证与代谢异常的相关性。方法:纳入PCOS患者593例,记录受试者年龄、血压、身高、体质量、毛发评分等,检测性激素、血糖、血清胰岛素、血脂代谢水平等。结果:593例PCOS患者脾虚证301例占50.76%;脾虚证PCOS患者体重指数(BMI)≥25kg/m2占92.35%(278/301),腰臀比≥0.8占98.67%(297/301),腰围≥80cm占97.01%(292/301),促黄体生成素(LH)/促卵泡生成素(FSH)>2占35.22%(106/301),睾酮>60ng/dL占33.55%(101/301),游离雄激素指数(FAI)>5.0占40.20%(121/301),雄烯二酮(AND)>3.0ng/mL占81.4%(245/301),总胆固醇(TC)>5.69mmol/L占16.28%(49/301),甘油三酯(TG)>1.7mmol/L占44.85%(135/301),低密度脂蛋白-胆固醇(LDL-C)>3.15mmol/L占38.54%(116/301),高密度脂蛋白-胆固醇(HDL-C)<1.3mmol/L占68.44%(206/301),胰岛素抵抗指数(HOMA-IR)≥2.69占66.78%(201/301),空腹血糖(FPG)≥5.6mmol/L占23.26%(70/301),空腹胰岛素(FINS)≥21μIU/mL占47.84%(144/301);合并代谢综合征(MetS)176例(29.56%),176例PCOS合并MetS患者脾虚证153例(86.93%);脾虚证PCOS患者可诊断为MetS占50.83%(153/301);具有全部5条MetS诊断危险因素的PCOS患者都是脾虚证(10/10)。脾虚证PCOS患者临床上表现出与PCOS合并MetS患者相似的代谢特征,其年龄、收缩压、舒张压、BMI、腰围、臀围、腰臀比、AND、FAI、性激素结合球蛋白、FINS、FPG、HOMA-IR、TC、TG、LDL-C、载脂蛋白A1(apoA1)、载脂蛋白B(apoB)和apoB/A1显著高于非脾虚证PCOS患者,HDL-C低于非脾虚证PCOS患者。结论:脾虚证PCOS易出现代谢异常表现,是MetS及各种代谢异常发生的高危人群。Objective:To investigate the relation between spleen-deficiency-syndrome(SDS)and metabolic abnormalities in patients with polycystic ovary syndrome(PCOS).Methods:593 patients with PCOS were included in this study,including the age,blood pressure,height,weight,hair score,etc.and measured the sex hormone,blood glucose,serum insulin and blood lipid metabolism.Results:There are 593 50.76%PCOS women with SDS.BMI≥25 kg/m2 SDS-PCOS accounts for 92.35%(278/301),waist-to-hip ratio≥0.8 for 98.67%(297/301),Waist circumference≥80 cm for 97.01%(292/301),LH/FSH>2 for 35.22%(106/301),T>60 ng/dL for 33.55%(101/301),FAI>5.0 for 40.20%(121/301),AND>3.0 ng/mL for 81.4%(245/301),TC>5.69 mmol/L for 16.28%(49/301),TG>1.7 mmol/L for 44.85%(135/301),LDL-C>3.15 mmol/L for 38.54%(116/301),HDL-C<1.3 mmol/L for 68.44%(206/301),HOMA-IR≥2.69 for 66.78%(201/301),FPG≥5.6 mmol/L for 23.26%(70/301),FINS≥21μIU/m for 47.84%(144/301).176 PCOS with metabolic syndrome(MetS)Accounts for 29.56%.153 PCOS with MetS were SDS.All diagnostic risk factors of MetS of PCOS are SDS(10/10).SDS-PCOS women showed similar metabolic characteristics with PCOS MetS women.Age,systolic pressure,diastolic blood pressure,BMI,waistline circumference,hip circumference,waist-hip-ratio,AND,FAI,sex hormone binding globulin,FINS,FPG,HOMA IR,TC,TG,LDL-C,apolipoprotein A1,apolipoprotein B,and apolipoprotein B/A1 were significantly higher than the non-SDS-PCOS,HDL-C significantly lower than the non-SDS-PCOS.Conclusion:SDS-PCOS is prone to metabolic abnormalities.SDS-PCOS are the high risker group of MetS and various metabolic abnormalities.PCOS patients with severe metabolic abnormalities are usually diagnosed SDS.

关 键 词：多囊卵巢综合征 脾虚证 代谢异常 代谢综合征 

分 类 号：R711.75[医药卫生—妇产科学]