CLINICAL PRACTICE. Polycystic Ovary Syndrome.
CLINICAL PRACTICE. Polycystic Ovary Syndrome.
复制标题
DOI：
10.1056/nejmcp1514916
复制
发表时间：
2016-07-07
期刊：
影响因子：
--
通讯作者：
Marshall JC
中科院分区：
文献类型：
--
作者：
McCartney CR;Marshall JC
一名22岁的女性报告有多毛症和月经不规律。她描述了自11岁初潮以来不可预测和不频繁的月经（每年5或6次）。深色、粗糙的面部毛发在13岁时开始生长。她在大学期间体重增加后，症状恶化了。体格检查包括身体质量指数（BMI，体重单位为公斤除以身高单位为米的平方）为29，血压为135/85毫米汞柱，中度多毛，无男性化。实验室检查显示总睾酮水平为每分升65纳克（每升2.3纳克）（测定参考范围，每分升14至53纳克[0.5至1.8纳克/升]），计算游离睾酮水平为每毫升15.3纳克（每升53.1纳克）（测定参考范围，每毫升0.6至6.8纳克[2.1至23.6纳克/升]），糖化血红蛋白水平为5.7%（正常值，≤5.6%）。该如何评估和管理这一病例？
A 22-year-old woman reports having hirsutism and irregular menses. She describes unpredictable and infrequent menses (five or six per year) since menarche at 11 years of age. Dark, coarse facial hair began to develop at 13 years of age. The symptoms worsened after she gained weight in college. The physical examination includes a body-mass index (BMI; the weight in kilograms divided by the square of the height in meters) of 29, blood pressure of 135/85 mm Hg, and moderate hirsutism without virilization. Laboratory tests reveal a total testosterone level of 65 ng per deciliter (2.3 nmol per liter) (assay reference range, 14 to 53 ng per deciliter [0.5 to 1.8 nmol per liter]), calculated free testosterone level of 15.3 pg per milliliter (53.1 pmol per liter) (assay reference range, 0.6 to 6.8 pg per milliliter [2.1 to 23.6 pmol per liter]), and glycated hemoglobin level of 5.7% (normal value, ≤5.6%). How should this case be evaluated and managed?