Premature ovarian failure.

Premature ovarian failure.
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DOI:
10.1186/1750-1172-1-9
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发表时间:
2006-04-06
影响因子:
3.7
通讯作者:
Persani L
Persani L
中科院分区:
医学2区
文献类型:
--
作者:
Beck-Peccoz P;Persani L

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卵巢早衰 (POF) 是一种原发性卵巢缺陷,其特征是 40 岁之前没有初潮(原发性闭经)或卵泡过早耗尽(继发性闭经)。这是一种异质性疾病,影响约 1% 的 40 岁以下女性,20 岁以下女性为 1:10,000,30 岁以下女性为 1:1,000。最严重的形式表现为青春期发育缺失和原发性闭经(其中 50% 的病例是由于卵巢发育不全),而青春期后发病的形式的特点是与卵泡过早相关的月经周期消失(继发性闭经)。 耗尽。与生理性更年期一样,POF 表现为更年期的典型表现:不孕伴有心悸、耐热、潮红、焦虑、抑郁、疲劳。 POF 的生化特征是性腺激素(雌激素和抑制素)水平低,促性腺激素(LH 和 FSH)水平高(促性腺激素过多性闭经)。除了不孕之外,激素缺陷还可能导致严重的神经、代谢或心血管后果,并导致骨质疏松症的早期发作。 POF的异质性还体现在多种可能的原因上,包括自身免疫、毒物、药物以及遗传缺陷。 POF 具有很强的遗传成分。 X染色体异常(例如特纳综合征)是与卵巢发育不全相关的原发性闭经的主要原因。尽管描述了几个候选基因,但在绝大多数病例中 POF 的病因仍未确定。治疗包括用雌激素/孕激素制剂替代激素缺陷。对于缺乏卵泡储备的女性的生育缺陷,目前唯一可用的解决方案是卵子捐赠。
Premature ovarian failure (POF) is a primary ovarian defect characterized by absent menarche (primary amenorrhea) or premature depletion of ovarian follicles before the age of 40 years (secondary amenorrhea). It is a heterogeneous disorder affecting approximately 1% of women <40 years, 1:10,000 women by age 20 and 1:1,000 women by age 30. The most severe forms present with absent pubertal development and primary amenorrhea (50% of these cases due to ovarian dysgenesis), whereas forms with post-pubertal onset are characterized by disappearance of menstrual cycles (secondary amenorrhea) associated with premature follicular depletion. As in the case of physiological menopause, POF presents by typical manifestations of climacterium: infertility associated with palpitations, heat intolerance, flushes, anxiety, depression, fatigue. POF is biochemically characterized by low levels of gonadal hormones (estrogens and inhibins) and high levels of gonadotropins (LH and FSH) (hypergonadotropic amenorrhea). Beyond infertility, hormone defects may cause severe neurological, metabolic or cardiovascular consequences and lead to the early onset of osteoporosis. Heterogeneity of POF is also reflected by the variety of possible causes, including autoimmunity, toxics, drugs, as well as genetic defects. POF has a strong genetic component. X chromosome abnormalities (e.g. Turner syndrome) represent the major cause of primary amenorrhea associated with ovarian dysgenesis. Despite the description of several candidate genes, the cause of POF remains undetermined in the vast majority of the cases. Management includes substitution of the hormone defect by estrogen/progestin preparations. The only solution presently available for the fertility defect in women with absent follicular reserve is ovum donation.
DOI: 10.1093/humupd/dmg038
发表时间: 2003-09-01
影响因子: 13.3
作者:
Hickey, M;Balen, A
通讯作者: Balen, A
DOI: 10.1172/jci3795
发表时间: 1998-10-01
影响因子: 15.9
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影响因子: 6.7
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DOI: 10.1086/422103
发表时间: 2004-07-01
影响因子: 9.8
作者:
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通讯作者: Persani, L
DOI: 10.1046/j.1365-2265.1999.00863.x
发表时间: 1999-12-01
影响因子: 3.2
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