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目的:分析总结多囊卵巢综合征(Polycystic ovary syndrome,PCOS)合并不育患者的临床及内分泌代谢特征,为PCOS的临床诊治提供依据。方法:回顾性分析120例PCOS患者(其中肥胖型73例,非肥胖型47例)的临床特征及内分泌、空腹血糖(FPG)、空腹胰岛素(FINS)等检查指标。用稳态模型胰岛素抵抗指数(HOMA-IR)、稳态模型胰岛素分泌指数(HOMA-IS)、空腹胰岛素敏感指数(ISI)评估胰岛素敏感性。结果:两组患者睾酮(T)、黄体生成素(LH)、卵泡刺激素(FSH)、LH/FSH无显著差别。肥胖组的FPG和FINS水平明显高于非肥胖组。两组胰岛素抵抗(IR)发生率分别为86.30%和51.06%。肥胖组的IR、ISI均明显高于非肥胖组。结论:PCOS患者肥胖发生率较高,肥胖型PCOS患者较非肥胖型患者存在更严重的代谢紊乱。减重、改善IR不仅可以改善PCOS不育情况,更是预防2型糖尿病、心血管疾病等远期并发症的关键。
OBJECTIVE: To analyze the clinical and endocrine and metabolic characteristics of patients with polycystic ovary syndrome (PCOS) complicated with infertility and provide the basis for the clinical diagnosis and treatment of PCOS. Methods: The clinical features, endocrine, fasting blood glucose (FPG) and fasting insulin (FINS) in 120 PCOS patients including 73 obese and 47 non-obese patients were retrospectively analyzed. Insulin sensitivity was assessed using homeostasis model insulin resistance index (HOMA-IR), homeostasis model insulin secretion index (HOMA-IS), and fasting insulin sensitivity index (ISI). Results: There was no significant difference between the two groups in testosterone (T), luteinizing hormone (LH), follicle stimulating hormone (FSH) and LH / FSH. The levels of FPG and FINS in obese group were significantly higher than those in non-obese group. The incidence of insulin resistance (IR) in both groups was 86.30% and 51.06%, respectively. The IR and ISI in obese group were significantly higher than those in non-obese group. Conclusion: The incidence of obesity is higher in patients with PCOS, and the patients with obese PCOS have more serious metabolic disorders than non-obese patients. Weight loss, improve IR not only can improve PCOS infertility, but also prevention of type 2 diabetes, cardiovascular disease and other long-term complications of the key.