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目的 总结多囊卵巢综合征 (PCOS)肥胖与非肥胖患者的临床特征及相关影响因素。方法 将 15 1例PCOS患者分为二组 ,体重指数大于或等于 2 5的为PCOSⅠ组 ;体重指数小于 2 5的为PCOSⅡ组。回顾分析两组的临床资料。用放射免疫法测定血清泌乳素、黄体生成素、卵泡刺激素、雌二醇、睾酮、雄烯二酮。结果 ①PCOSⅠ组的雄烯二酮、糖负荷后 6 0、12 0min血糖、血糖曲线下面积、空腹胰岛素、糖负荷后 6 0、12 0min胰岛素及胰岛素释放曲线下面积均显著高于PCOSⅡ组 (P均 <0 0 5 ) ;②PCOSⅠ组中A、T与胰岛素曲线下面积呈正相关(P <0 0 5 ) ;PCOSⅡ组中LH与A呈正相关 (P <0 0 1)。结论 ①肥胖的PCOS患者的临床内分泌紊乱更严重 ;②肥胖PCOS的高雄激素血症的形成可能是胰岛素抵抗所致 ,而非肥胖PCOS患者的高雄激素血症主要受LH的影响。
Objective To summarize the clinical characteristics and related factors of obese and nonobese patients with polycystic ovary syndrome (PCOS). Methods One hundred and fifteen PCOS patients were divided into two groups: the PCOSⅠ group with a body mass index greater than or equal to 2.5, and the PCOSⅡ group with a body mass index less than 2.5. Retrospective analysis of the clinical data of two groups. Serum prolactin, luteinizing hormone, follicle stimulating hormone, estradiol, testosterone and androstenedione were determined by radioimmunoassay. Results ① The area under the curve of glucose and glucose, the area under the curve of blood glucose, the fasting insulin and the area under the curve of insulin release and insulin release at 60, 120 min after PCOS Ⅰ group were significantly higher than that of PCOS Ⅱ group (P (P <0.05). There was a positive correlation between A, T and the area under the insulin curve in PCOSⅠgroup (P <0.01). There was a positive correlation between LH and A in PCOSⅡgroup (P <0.01). Conclusion ① The clinical endocrine disorders in obese patients with PCOS are more serious. ② The formation of hyperandrogenism in obese PCOS may be caused by insulin resistance, while the hyperandrogenism in non-obese patients with PCOS is mainly affected by LH.