Epidemiology, diagnosis, and management of polycystic ovary syndrome.
Epidemiology, diagnosis, and management of polycystic ovary syndrome.
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DOI：
10.2147/clep.s37559
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发表时间：
2013-12-18
影响因子：
3.9
通讯作者：
Pate KA
中科院分区：
文献类型：
--
作者：
Sirmans SM;Pate KA
多囊卵巢综合征(PCOS)是一种常见的以月经不调、高雄激素血症和多囊卵巢为特征的异质性内分泌疾病。根据诊断标准的不同，多囊卵巢综合征的患病率也不同，但如果使用欧洲人类生殖与胚胎学协会/美国生殖医学协会的标准，多囊卵巢综合征的患病率高达15%-20%。临床表现包括月经过少或闭经、多毛症和经常不孕。成人多囊卵巢综合征的危险因素包括1型糖尿病、2型糖尿病和妊娠期糖尿病。胰岛素抵抗影响50%-70%患有多囊卵巢综合征的女性，导致许多共病，包括代谢综合征、高血压、血脂异常、糖耐量异常和糖尿病。研究表明，患有多囊卵巢综合征的女性更有可能有冠状动脉钙化评分增加和颈动脉内膜-中层厚度增加。包括抑郁、焦虑、躁郁症和暴饮暴食在内的精神健康障碍在患有多囊卵巢综合征的女性中也更常见。减肥可以改善月经不调、雄激素过多的症状和不孕症。多囊卵巢综合征临床表现的处理包括口服避孕药治疗月经不调和多毛症。螺内酯和非那雄胺用于治疗雄激素过多的症状。不孕症的治疗选择包括克罗米芬、腹腔镜卵巢打孔术、促性腺激素和辅助生殖技术。最近的数据表明，来曲唑和二甲双胍可能在诱导排卵中发挥重要作用。正确诊断和处理多囊卵巢综合征对于解决患者的担忧以及预防未来的代谢、内分泌、精神和心血管并发症是至关重要的。
Polycystic ovary syndrome (PCOS) is a common heterogeneous endocrine disorder characterized by irregular menses, hyperandrogenism, and polycystic ovaries. The prevalence of PCOS varies depending on which criteria are used to make the diagnosis, but is as high as 15%–20% when the European Society for Human Reproduction and Embryology/American Society for Reproductive Medicine criteria are used. Clinical manifestations include oligomenorrhea or amenorrhea, hirsutism, and frequently infertility. Risk factors for PCOS in adults includes type 1 diabetes, type 2 diabetes, and gestational diabetes. Insulin resistance affects 50%–70% of women with PCOS leading to a number of comorbidities including metabolic syndrome, hypertension, dyslipidemia, glucose intolerance, and diabetes. Studies show that women with PCOS are more likely to have increased coronary artery calcium scores and increased carotid intima-media thickness. Mental health disorders including depression, anxiety, bipolar disorder and binge eating disorder also occur more frequently in women with PCOS. Weight loss improves menstrual irregularities, symptoms of androgen excess, and infertility. Management of clinical manifestations of PCOS includes oral contraceptives for menstrual irregularities and hirsutism. Spironolactone and finasteride are used to treat symptoms of androgen excess. Treatment options for infertility include clomiphene, laparoscopic ovarian drilling, gonadotropins, and assisted reproductive technology. Recent data suggest that letrozole and metformin may play an important role in ovulation induction. Proper diagnosis and management of PCOS is essential to address patient concerns but also to prevent future metabolic, endocrine, psychiatric, and cardiovascular complications.