Characterization of idiopathic premature ovarian failure
Characterization of idiopathic premature ovarian failure
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DOI：
10.1016/s0015-0282(16)58095-9
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发表时间：
1996-02-01
影响因子：
6.7
通讯作者：
Jacobs, HS
中科院分区：
文献类型：
--
作者：
Conway, GS;Kaltsas, G;Jacobs, HS
目的：探讨特发性卵巢早衰(POF)患者的卵巢超声表现，以确定其卵泡活动的发生率及其与自身免疫、雌激素状态和病史背景的关系。设计：对临床、内分泌、自身免疫、超声和骨密度参数进行回顾性分析。地点：英国伦敦米德尔塞克斯医院生殖内分泌科诊所。对18名卵巢功能正常的妇女在卵泡期进行研究，以比较内分泌和超声数据。对57例卵巢功能正常的妇女进行骨密度测定比较。主要观察指标：血清E(2)浓度、自身抗体筛查、超声测量卵巢体积、子宫横截面积、子宫内膜厚度和腰椎双侧X线片骨密度。结果：超声检测卵巢(76%)和卵泡活动(60%)与卵巢不能识别的患者相比，骨密度较高。在13例表现为原发闭经的患者中，超声检查发现62%的患者卵巢和38%的卵泡，而38%的患者有阳性的自身免疫。在31%的患者中发现了自身免疫的证据，这些证据与每一方面的非自身免疫残留物都没有区别。结论：以前被认为是罕见的卵泡活动，就像“抵抗卵巢综合征”一样，通过盆腔超声在大多数POF妇女中发现。原发闭经患者的卵巢功能和自身免疫功能与继发性闭经患者相似。通过本研究的测量，自身免疫在POF发病机制中的作用与非自身免疫性卵巢损害没有区别。
Objective: To characterize women with idiopathic premature ovarian failure (POF) by their ovarian ultrasonographic appearances to establish the prevalence of follicular activity and relationship to autoimmunity, estrogen status, and historical background.Design: Retrospective analysis of clinical, endocrine, autoimmune, ultrasonographic, and bone densitometry parameters.Setting: Reproductive Endocrinology Clinics of The Middlesex Hospital, London, United Kingdom.Patients: Data from 135 women with idiopathic POF were analyzed. A reference group of 18 women with normal ovarian function, studied in their follicular phase, was used for comparison of endocrine and ultrasound data. A reference group of 57 women with normal ovarian function was used for comparison of bone densitometry measurements.Main Outcome Measures: Serum E(2) concentrations, autoantibody screen, ultrasonographic measures of ovarian volume, uterine cross-sectional area and endometrial thickness and dual roentgenogram bone mineral densitometry of the lumbar spine.Results: The detection of ovaries by ultrasound (in 76%) and follicular activity (in 60% of patients) was associated with higher bone mineral density compared with women in whom ovaries could not be identified. Of 13 patients presenting with primary amenorrhea, ultrasonography identified ovaries in 62% and follicles in 38% whereas 38% had positive autoimmunity. Evidence of autoimmunity was found in 31% of patients overall and these were indistinguishable from the nonautoimmune remainder in every respect.Conclusions: Ovarian follicular activity, previously considered to be rare, as in the ''resistant ovary syndrome,'' is found in the majority of women with POF using pelvic ultrasonography. Patients presenting with primary amenorrhea have a similar degree of ovarian function, determined by ultrasound, and autoimmunity as those presenting with secondary amenorrhea. The role of autoimmunity in the pathogenesis of POF is not distinguished from nonautoimmune ovarian damage by the measurements made in this study.