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目的探讨多囊卵巢综合征(PCOS)的病因、发病机理及寻找最佳的治疗方案提供依据。方法通过放射免疫(RIA)法测患者胰岛素释放试验,酶法测糖耐量试验,电化学发光免疫分析(ECLIA)法测血清LH、FSH、E2、P、T水平。结果表明28.2%患者有胰岛素抵抗(IR),13.1%有IR和糖耐量受损,5.5%糖耐量受损。单纯IR患者中,肥胖者占35.7%;单纯糖耐量受损者中,肥胖者占36.3%;IR伴糖耐量受损者中,肥胖者占34.6%;肥胖组LH、LH/FSH、E2、T水平与非肥胖组之间无显著性差异(P>0.05);而肥胖组与非肥胖的空腹血糖及空腹胰岛素水平有显著性差异(P<0.05);肥胖者与非肥胖者月经周期及卵泡数目两指标有显著性差异(P<0.05)。结论有较多PCOS患者存在IR或糖耐量受损;在IR和糖耐量受损的患者中,肥胖者占有较高的比重,肥胖可促进IR形成;肥胖可加重IR和生殖功能障碍。
Objective To investigate the etiology and pathogenesis of polycystic ovary syndrome (PCOS) and find out the best treatment plan. Methods The levels of serum LH, FSH, E2, P and T were measured by radioimmunoassay (RIA) in patients with insulin release test, enzymatic glucose tolerance test and ECLIA. The results showed that 28.2% of patients had insulin resistance (IR), 13.1% had impaired IR and impaired glucose tolerance, and 5.5% impaired glucose tolerance. Among the patients with IR alone, 35.7% were obese, 36.3% were obese with simple impaired glucose tolerance, 34.6% were obese with IR impaired glucose tolerance, and those with LH, LH / FSH, E2, There was no significant difference between T level and non-obese group (P> 0.05), but there was significant difference between fasting blood glucose and fasting insulin level in obesity group and non-obese group (P <0.05) The number of follicles between the two indicators were significantly different (P <0.05). Conclusion There are more patients with PCOS IR or impaired glucose tolerance; IR and impaired glucose tolerance patients, obese occupy a higher proportion of obesity can promote the formation of IR; obesity can aggravate IR and reproductive dysfunction.