达英-35治疗多囊卵巢综合征合并不孕症的疗效及对患者血清FSH、LH、TOS、TAS水平的影响

摘要 目的：研究达英-35治疗多囊卵巢综合征合并不孕症的疗效及对患者血清卵泡刺激素(FSH)、促黄体生成素(LH)、总氧化态(TOS)、抗氧化态(TAS)水平的影响。方法：选取2015年8月至2016年7月我院收治的76例多囊卵巢综合征合并不孕症患者,根据随机数字法分为观察组和对照组,38例每组。对照组使用克罗米芬,观察组在此基础上加以达英-35。比较两组患者临床疗效,治疗前后血清FSH、LH、TOS、TAS水平、卵泡数、卵巢体积、体重指数的变化及不良反应的发生情况。结果：治疗后,观察组临床总有效率显著高于对照组[89.47%(34/38) vs. 60.53%(23/38)](P<0.05);两组患者的血清FSH、LH、TOS水平、卵泡数、卵巢体积、体重指数明显减少较治疗前均显著降低(P<0.05),而血清TAS水平较治疗前显著上升(P<0.05),且观察组的血清FSH、LH、水平明显低于对照组(P<0.05),而血清TAS水平显著高于对照组(P<0.05)。观察组和对照组的不良反应的发生率比较无明显差异(P>0.05)。结论：达英-35治疗多囊卵巢综合征合并不孕症患者能有效提高患者的临床疗效和改善其临床症状,且安全性高,这可能与其有效改善患者血清FSH、LH、TOS、TAS水平有关。     

穴位埋线联合益肾化痰方对多囊卵巢综合征患者T、E2、LH水平影响

摘要 目的：探讨穴位埋线联合益肾化痰方对多囊卵巢综合征患者睾酮(testosterone,T)、雌二醇(estradiol,E₂)、黄体生成素(luteinizing hormone,LH)水平影响。方法：选取2018年1月至2019年6月我院收治的120例多囊卵巢综合征患者作为研究对象,随机将其分为两组,对照组60例,给予益肾化痰方治疗,研究组60例,在对照组的基础上联合穴位埋线治疗。观察两组治疗后的疗效及不良反应率,检测两组治疗后子宫内膜厚度、成熟卵泡数以及治疗前后T、E₂、LH水平变化情况。结果：研究组治疗的总有效率为 98.33 %,显著高于对照组治疗的总有效率（85.0 %,P＜0.05）。两组治疗后子宫内膜厚度及成熟卵泡数比较,研究组明显高于对照组(P＜0.05)。两组治疗前T、E₂、LH水平指标比较差异无统计学意义（P>0.05）;两组治疗后T、E₂、LH水平指标比较差异有统计学意义（P<0.05）。对照组头痛3例,恶心4例,不良反应率为11.67 %;研究组头痛1例,不良反应率为1.67 %,两组患者不良反应率比较有统计学意义（P<0.05）。结论：埋线联合益肾化痰方治疗多囊卵巢综合征患者,能有效的提高治疗疗效,改善患者T、E2、LH水平,促进排卵,安全可靠,值得临床推广和应用。     

定坤丹对多囊卵巢综合征患者性激素水平、胰岛素抵抗及妊娠情况的影响

目的:探讨定坤丹对多囊卵巢综合征患者性激素水平、胰岛素抵抗及妊娠情况的的影响。方法:选择2016年5月至2018年5月我院收治的210例多囊卵巢综合征患者,根据随机化原则将其分为两组,每组105例。对照组患者接受达英-35与二甲双胍治疗,研究组在对照组的基础上口服定坤丹治疗。连续治疗3个月后,比较两组治疗前后的性激素水平及胰岛各相关指标的变化。治疗结束后随访1年,比较两组的排卵及妊娠情况。结果:与治疗前相比,两组治疗后的血清睾酮(Testosterone,T)、黄体生成素(Luteinizing hormone,LH)及LH/FSH均明显降低,且研究组以上指标均显著低于对照组(P<0.05)。两组治疗前后的卵泡刺激素(Follicle-stimulating hormone,FSH)水平比较无统计学差异(P>0.05)。与治疗前相比,两组治疗后的空腹胰岛素(Fasting insulin,FINS)、餐后2 h胰岛素(Postprandial 2 hours insulin,2hPINS)及β细胞胰岛素分泌功能(Homeostasis model assessment ofβcell,HOMA-β)均明显升高,胰岛素敏感指数(Homeostasis model assessment-Insulin sensitivity index,HOMA-IS)明显降低,且研究组以上指标较对照组改善更明显(P<0.05)。研究组排卵及成功妊娠率均显著高于对照组(P<0.05)。结论:定坤丹有助于改善多囊卵巢综合征患者性激素水平及胰岛素抵抗,提高排卵及妊娠率。     

百令胶囊对多囊卵巢综合征患者卵泡液骨形态蛋白、生长分化因子-9及胰岛素样生长因子的影响

目的:探讨百令胶囊对多囊卵巢综合征患者卵泡液骨形态蛋白(BMP)、生长分化因子(GDF)-9及胰岛素样生长因子(IGF)的影响。方法:选择2013年7月至2016年7月我院接诊的90例多囊卵巢综合征患者,通过随机数表法分为观察组(n=45)和对照组(n=45),对照组使用达英-35治疗,观察组在此基础上使用百令胶囊。比较两组糖代谢指标、内分泌指标、卵泡液BMP-15、GDF-9、IGF-1水平的变化以及临床疗效。结果:治疗后,观察组空腹血糖(FBG)、空腹胰岛素(FINS)、胰岛素抵抗(HOMA-IR)、血清卵泡刺激素(FSH)、黄体生成素(LH)、睾酮(T)水平水平均显著低于对照组(P0.05),卵泡液BMP-15、GDF-9水平显著高于对照组,IGF-1水平明显低于对照组(P0.05),总有效率显著高于对照组(P0.05)。结论:百令胶囊质量多囊卵巢综合征效果显著,可有效调节内分泌,并改善卵泡液BMP-15、GDF-9、IGF-1的水平。     

来曲唑联合妈富隆治疗多囊卵巢综合征患者的疗效探讨

目的:探讨来曲唑联合妈富隆治疗多囊卵巢综合征患者的临床疗效。方法:选择2015年12月至2017年12月我院接诊的90例多囊卵巢综合征患者,通过随机数表法分为观察组(n=46)和对照组(n=44)。对照组给予妈富隆治疗,观察组联合来曲唑治疗。比较两组治疗前后血清卵泡刺激素(FSH)、黄体生成素(LH)、睾酮(T)、血清血管内皮生长因子(VEGF)、内皮抑素(ES)、肝细胞生长因子(HGF)、单核细胞趋化蛋白-1(MCP-1)水平的变化和治疗后的临床疗效,并随访半年,记录排卵率和妊娠率。结果:治疗后,两组血清FSH、LH、T、VEGF、ES、HGF、MCP-1水平均较治疗前明显降低(P0.05),且观察组以上指标均明显低于对照组(P0.05);观察组临床总有效率[91.30%vs. 75.00%]、排卵率[78.26%vs. 36.96%]、妊娠率[59.09%vs. 5.91%]均明显高于对照组(P0.05)。结论:来曲唑联合妈富隆治疗多囊卵巢综合征的临床效果显著优于妈富隆单药治疗,其可有效改善患者内分泌,提高妊娠率,可能与降低血清VEGF、ES、HGF、MCP-1的表达相关。     

多囊卵巢综合征和肠道菌群的关系及中药防治研究现状

多囊卵巢综合征是育龄期女性最常见的疾病之一,以多种内分泌代谢紊乱为特征。近年来的研究发现肠道菌群和多囊卵巢综合征的发生发展相关,肠道菌群和中医的关系已成为研究热点。本文分析了肠道菌群及其代谢产物和肠道屏障在多囊卵巢综合征发生发展中的作用,总结了单味中药和复方中药通过影响肠道菌群改善多囊卵巢综合征的研究进展。今后研究中应进一步探索与多囊卵巢综合征相关的特异菌属,探索中药有效成分及作用靶点,为中医治疗多囊卵巢综合征提供新思路。     

消囊调经汤联合达英-35对多囊卵巢综合征患者性激素、脂代谢和卵巢间质血流的影响

摘要 目的：观察消囊调经汤联合达英-35对多囊卵巢综合征（PCOS）患者性激素、脂代谢和卵巢间质血流的影响。方法：选择2020年7月~2022年12月期间河南省中医院收治的PCOS患者117例。按照随机数字表法分为对照组（达英-35,58例）和研究组（消囊调经汤联合达英-35,59例）。对比两组性激素指标[促黄体生成素（LH）、雌二醇（E₂）、促卵泡生成素（FSH）、 睾酮（T）]、中医证候积分、脂代谢[高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、甘油三酯（TG）、总胆固醇（TC）]和卵巢间质血流情况[子宫动脉搏动指数（PI）、子宫动脉阻力指数（RI）]。结果：研究组治疗后主症积分、次症积分、总积分低于对照组（P<0.05）。研究组治疗后LH、E₂、FSH、T低于对照组（P<0.05）。研究组治疗后HDL-C高于对照组;TC、TG、LDL-C低于对照组（P<0.05）。研究组治疗后PI、RI低于对照组（P<0.05）。结论：消囊调经汤联合达英-35治疗PCOS患者,可改善患者的临床症状,调节机体性激素、脂代谢和卵巢间质血流,疗效较好。     

补肾活血中药加克罗米芬治疗多囊卵巢综合征所致不孕症的临床观察

目的观察补肾活血中药加克罗米芬治疗多囊卵巢综合征致不孕症的临床疗效。方法随机抽取我院2013年6月~2014年6月收治的多囊卵巢综合征致不孕症患者50例为观察组,采用补肾活血中药加克罗米芬治疗;同时抽取同期患者50例为对照组,采用克罗米芬治疗。观察比较两组患者的治疗效果。结果观察组治疗总有效率为94.0%,优于对照组的70.0%,差异具有显著统计学意义(χ2=13.25,P0.05);两组患者SHBG、排卵情况、月经量化评分分析,观察组均优于对照组(t/χ2分别为7.501,13.64,2.43,均P0.05)。结论补肾活血中药加克罗米芬治疗多囊卵巢综合征致不孕症具有较为理想的治疗效果,可在临床上推广使用。     

经阴道卵巢打孔术治疗克罗米酚耐药性多囊卵巢综合征

目的：研究超声引导下经阴遣卵巢打孔术（TOD）治疗克罗米酚（CC）耐药性多囊卵巢综合征（PCOS）不孕患者的排卵和妊娠情况。方法：2003年12月至2005年06月就诊的CC耐药PCOS患者,阴道超声介导下经阴道卵巢打孔。术后常规用CC＋补佳乐促排卵方案,观察排卵率和妊娠情况,并随访1年内妊娠情况。结果：38例患者采用经阴道卵巢打孔术治疗后血清睾酮较初诊时明显下降（p〈0．04）。术后第1周期21人有排卵,排卵率55．26％。另18人仍然无效。第1周期有3例妊娠,1例流产。第1周期后再用促排卵药B超监测有排卵或自然周期BBT双相但未怀孕7例。随访6月内共5例妊娠。结论：对于CC耐药的PCOS患者,采用超声引导下经阴道卵巢打孔技术是继腹腔镜下卵巢打孔术之后一种简便、有效的选择。     

二甲双胍+克罗米芬治疗多囊卵巢综合征合并不孕的效果观察

目的探讨二甲双胍联合克罗米芬治疗多囊卵巢综合征合并不孕的临床效果。方法选择2014年1月~2015年12月我院收治的多囊卵巢综合征合并不孕患者80例,随机分为研究组和对照组,研究组采用二甲双胍+克罗米芬治疗,对照组采用克罗米芬治疗,并随访12个月进行两组疗效比较。结果治疗后,两组患者的睾酮、促卵泡雌激素、促黄体生成素、空腹胰岛素水平比较,差异有统计学意义(P0.05);两组患者的排卵率、妊娠率、早孕流产率比较,差异有统计学意义(P0.05)。结论二甲双胍与克罗米芬联合治疗多囊卵巢综合征合并不孕的临床效果理想,值得推广应用。     

A Model Combining Testosterone,Androstenedione and Free Testosterone Index Improved the Diagnostic Efficiency of Polycystic Ovary Syndrome

ObjectiveHyperandrogenism is frequently observed in patients with polycystic ovary (PCO). The purpose of this study was to develop an easy-to-use tool for predicting polycystic ovary syndrome (PCOS) and to evaluate and compare the value of androstenedione (Andro) and other hormone indicators in the diagnosis of patients with hyperandrogenic PCOS.MethodsThis study included 139 women diagnosed with hyperandrogenic PCOS according to the Rotterdam criteria and 74 healthy control women from Shanghai Tenth People's Hospital. The serum hormone levels of the patients and controls were measured using a chemiluminescence immunoassay and incorporated for further analysis.ResultsTotal testosterone (TT), Andro, dehydroepiandrosterone sulfate (DHEAS), and free androgen index (FAI) were significantly higher in the PCOS group than the control group. Further, Andro, follicle-stimulating hormone (FSH), luteinizing hormone (LH), TT, FAI, and LH/FSH in the hyperandrostenedione group were higher than the normal Andro group. The Youden index was the highest for Andro (0.65), with 81.82% sensitivity and 83.16% specificity. Correlation analysis showed that FSH, LH, TT, FAI, insulin sensitivity index, and LH/FSH were positively correlated with Andro, while fasting blood glucose and 2-hour postprandial blood glucose were negatively correlated with Andro.ConclusionsThe model using Andro, TT, and FAI may help to identifying women with undiagnosed PCOS. Serum Andro is a meaningful biomarker for hyperandrogenism in PCOS patients and may further aid disease diagnosis.     

Increase in daily LH secretion in response to short-term calorie restriction in obese women with PCOS

We hypothesized that short-term calorie restriction would blunt luteinizing hormone (LH) hypersecretion in obese women with polycystic ovary syndrome (PCOS) and thereby ameliorate the anovulatory endocrine milieu. To test this hypothesis, 15 obese patients with PCOS and nine age- and body mass index-matched healthy women underwent 24-h blood sampling to quantitate plasma LH, leptin, and insulin levels. PCOS subjects were prescribed a very low caloric liquid diet (4.2 MJ/day) for 7 days and were then resampled. Basal and pulsatile LH secretion was threefold higher in PCOS subjects, but plasma insulin and leptin levels were not different in the calorie-replete state. Contrary to expectation, calorie restriction enhanced basal and pulsatile LH secretion even further. As expected, plasma glucose, insulin, and leptin concentrations decreased by 18, 75, and 50%, respectively. Serum total testosterone concentration fell by 23%, whereas serum estrone, estradiol, sex hormone-binding globulin (SHBG), and androstenedione concentrations remained unchanged. Enhanced LH secretion in the presence of normal metabolic and hormonal adaptations to calorie restriction points to anomalous feedback control of pituitary LH release in PCOS.     

多囊卵巢综合征患者血清抗苗勒管激素与肥胖、胰岛素抵抗程度的相关性分析

目的:探讨多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者血清抗苗勒管激素(anti-Müllerian hormone,AMH)水平与肥胖、胰岛素抵抗(insulin resistance,IR)程度的相关性。方法:选择在我院生殖中心就诊的139名PCOS患者为研究组,并以月经周期正常、因输卵管因素或男性因素导致不孕者48名作为对照组。检测和比较PCOS患者的血清AMH、性激素水平及代谢指标,分析血清AMH水平与PCOS患者肥胖、胰岛素抵抗程度的关系。结果:PCOS组患者体质量指数(body mass index,BMI)、黄体生成素(luteinizing hormone,LH)、睾酮(testosterone,T)、垂体泌乳素(pituitary prolactin PRL)、空腹血糖(fasting plasma glucose,FPG)、空腹胰岛素(fasting insulin,FINS)、稳态模型胰岛素抵抗指数(homenostasis models assessment-insulin resistance index,HOMA-IR)的水平均显著高于对照组(P0.05),PCOS组和对照组年龄、卵泡刺激素(follicle stimulating hormone,FSH)比较差异无统计学意义(P0.05)。PCOS各表型组的血清AMH浓度、LH/FSH比值均明显高于对照组(P0.05)。肥胖组患者的AMH浓度低于正常体重组,BMI、FPG、FINS、HOMA-IR、甘油三脂(triglycerides,TG)水平均高于正常体重组,LH、LH/FSH、高密度脂蛋白(high density lipoprotein,HDL-C)水平均低于正常体重组(P0.05)。高HOMA-IR组患者的血清AMH浓度、LH、LH/FSH水平均明显低于低HOMA-IR组,BMI、T、FPG、FINS、TG、低密度脂蛋白(low density lipoprotein,LDL-C)水平均高于低HOMA-IR组(P0.05)。PCOS患者血清AMH浓度和BMI及HOMA-IR均存在显著负相关。结论:PCOS患者血清的AMH水平较对照组明显升高,与其肥胖、胰岛素抵抗(IR)程度呈显著负相关。     

Exaggerated 17-hydroxyprogesterone response to intravenous infusions of recombinant human LH in women with polycystic ovary syndrome

Studies using pharmacological gonadotropin stimulation suggest that ovarian steroidogenesis is abnormal in the polycystic ovary syndrome (PCOS). We assessed ovarian steroid secretion in response to near-physiological gonadotropin stimuli in 12 ovulatory controls and 7 women with PCOS. A gonadotropin-releasing hormone-receptor antagonist (ganirelix, 2 mg sc) was given to block endogenous LH secretion, followed by dexamethasone (0.75 mg orally) to suppress adrenal androgen secretion. After ganirelix injection (12 h), intravenous infusions of recombinant human LH (0, 10, 30, 100, and 300 IU; each over 8 min) were administered at 4-h intervals in a pseudorandomized (highest dose last) manner. Plasma LH, 17-hydroxyprogesterone (17-OHP), androstenedione, and testosterone were measured concurrently. LH dose-steroid response relationships (mean sex-steroid concentration vs. mean LH concentration over 4 h postinfusion) were examined for each subject. Linear regression of 17-OHP on LH yielded a higher (mean +/- SE) slope in PCOS (0.028 +/- 0.010 vs. 0.005 +/- 0.005, P < 0.05), whereas extrapolated 17-OHP at zero LH was similar. The slopes of other regressions did not differ from zero in either PCOS or controls. We conclude that near-physiological LH stimulation drives heightened 17-OHP secretion in patients with PCOS, suggesting abnormalities of early steps of ovarian steroidogenesis. With the exception of 17-OHP response in PCOS, no acute LH dose-ovarian steroid responses were observed in controls or PCOS. Defining the precise mechanistic basis of heightened precursor responsiveness to LH in PCOS will require further clinical investigation.     

痰湿体质PCOS临床特征及T淋巴细胞亚群分布特征分析

目的:探讨痰湿体质多囊卵巢综合征患者临床特征及T淋巴细胞亚群分布特征。方法:根据PCOS鹿特丹诊断标准和王琦教授痰湿体质的判定标准,选择痰湿体质PCOS患者、非痰湿体质PCOS患者各30例,正常对照组15例进行性激素和糖脂代谢指标检测和T淋巴细胞亚群检测,明确痰湿体质PCOS患者临床特征及T淋巴细胞亚群的分布特征。结果:三组在年龄和体重指数上无差异,具有可比性;痰湿体质PCOS与非痰湿体质PCOS在LH、T、30 min INS、120 min INS、CHO、LDL水平明显高于对照组,具有统计学意义(P0.05);痰湿体质组OGTT血糖水平、CHO、LDL、IR水平明显高于非痰湿体质组,差异具有统计学意义(P0.05)。痰湿体质、非痰湿体质PCOS患者外周血CD4+T淋巴细胞、CD4+/CD8+明显高于对照组,且痰湿体质PCOS患者CD4+T淋巴细胞、CD4+/CD8+明显高于非痰湿体质PCOS患者,差异有显著性(P0.05)。结论:PCOS患者存在糖脂代谢紊乱,其中痰湿体质患者较非痰湿体质患者更明显;PCOS患者存在细胞免疫异常,痰湿体质患者较非痰湿体质患者更易出现T淋巴细胞亚群异常,说明痰湿体质PCOS的发生与免疫因素关系更密切。     

Role of luteinizing hormone β-subunit gene variants among South Indian women with polycystic ovary syndrome

Abnormal luteinizing hormone (LH) secretion and action are known to affect ovarian steroidogenesis and thus playing a crucial role in manifestation of polycystic ovary syndrome (PCOS). This study is first of its kind to study association of LH β-subunit gene variants with PCOS among South-Indian women. 250 PCOS cases and 299 controls were recruited for the study. All the exons of LH β gene were screened. Allele and genotype frequencies of the SNPs were compared between the cases and controls. We identified seven SNPs in the LH β gene; one SNP in exon 3 (rs#1056917) exhibited significant difference in the allele frequency between the PCOS cases and controls (p = 0.015). Although, the LH β variants that are found to be more frequent among PCOS cases are silent in nature and not of any functional significance, they might influence other significant functional polymorphisms in the hypothalamic-pituitary-gonadal axis which needs to be explored.     

Anti-Mullerian hormone levels reflect severity of PCOS but are negatively influenced by obesity: relationship with increased luteinizing hormone levels

The objective of the study was the comparison of anti-Müllerian hormone (AMH) levels among obese or overweight and normal-weight women with the four different polycystic ovary syndrome (PCOS) phenotypes and healthy control subjects. AMH levels were evaluated in four age- and body mass index (BMI)-matched groups of 25 normal-weight and 25 obese or overweight women each, belonging to the four main subsets of the syndrome resulting from combinations of the three diagnostic criteria [group 1: oligo- and/or anovulation (ANOV), hyperandrogenemia (HA), and polycystic ovaries (PCO) on ultrasonographic evaluation; group 2: ANOV and HA; group 3: HA and PCO, group 4: ANOV and PCO], and in 50 (25 obese or overweight and 25 normal weight) age- and BMI-matched healthy control subjects. Age, BMI, waist circumference, FSH, LH, prolactin, testosterone, Delta(4)-androstenedione, dehydroepiandrosterone-sulfate, 17alpha-OH-progesterone, fasting insulin, glucose, AMH, free androgen index, and homeostasis model assessment for insulin resistance index were analyzed. AMH levels were significantly higher in PCOS groups 1 and 2 compared with groups 3 and 4 and the control group and higher in PCOS groups 3 and 4 compared with the control group. AMH levels were significantly increased in normal-weight compared with obese and overweight women. AMH concentrations were independently predicted, in order of significance, by LH and testosterone levels, BMI (negatively), and the total number of follicles 2-9 mm in diameter. The differences in circulating AMH levels between the main phenotypic groups of PCOS women appear to reflect the severity of the syndrome, but are negatively affected by obesity. Increased LH levels might be the most significant independent link between PCOS-associated disorders of ovulation and the observed increase in circulating AMH concentration.     

血清OC、TSP-1、ANGPTL2与多囊卵巢综合征患者胰岛素抵抗、性激素和卵巢间质血流的关系研究

摘要 目的：分析血清骨钙素（OC）、血小板反应蛋白-1（TSP-1）、血管生成素样蛋白2（ANGPTL2）与多囊卵巢综合征（PCOS）患者胰岛素抵抗（IR）、性激素和卵巢间质血流的关系。方法：选取2020年1月～2022年4月内蒙古自治区人民医院收治的125例PCOS患者（PCOS组）,根据稳态模型评估（HOMA）-IR分为IR组68例和非IR组57例,另选取同期67例体检健康成年女性（对照组）。收集研究对象HOMA-IR和性激素、卵巢间质血流指标,采用酶联免疫吸附法检测血清OC、TSP-1、ANGPTL2水平。比较PCOS组与对照组、IR组与非IR组之间性激素、卵巢间质血流指标、血清OC、TSP-1、ANGPTL2水平的差异。采用Pearson/Spearman相关性分析法分析PCOS患者血清OC、TSP-1、ANGPTL2水平与HOMA-IR、性激素和卵巢间质血流指标的相关性。结果：PCOS组HOMA-IR、黄体生成素（LH）、LH/促卵泡生成素（FSH）、睾酮（T）、收缩期峰值速度（PSV）、ANGPTL2水平高于对照组,搏动指数（PI）和阻力指数（RI）、OC、TSP-1水平低于对照组（P＜0.05）。IR组LH、LH/FSH、T、PSV、ANGPTL2水平高于非IR组,PI、RI、OC、TSP-1水平低于非IR组（P＜0.05）。Pearson/Spearman相关性分析显示,PCOS患者血清OC、TSP-1水平与HOMA-IR、LH、LH/FSH、T、PSV呈负相关,与PI、RI呈正相关（P＜0.05）;血清ANGPTL2水平与PCOS患者HOMA-IR、LH、LH/FSH、T、PSV呈正相关,与PI、RI呈负相关（P＜0.05）。结论：血清OC、TSP-1在PCOS患者血清中低表达,ANGPTL2在PCOS患者血清中高表达,三者与PCOS患者IR、性激素和卵巢间质血流密切相关。     

新疆维汉民族多囊卵巢综合征患者CYP17基因多态性及与发病机制的关系

目的:探讨细胞色素P450酶17(CYP17)基因多态性及其与多囊卵巢综合征(PCOS)发病机制的关系。方法:选择2015年1月~2017年2月我院收治的新疆维汉民族PCOS患者260例为PCOS组,另选取同期在我院门诊检查的健康育龄妇女237例为对照组,采用限制性片段长度多态性聚合酶链反应(PCR-RFLP)技术检测两组受试者的CYP17基因多态性,比较两组等位基因及基因频率的分布,结合其临床资料分析CYP17基因多态性与PCOS发病机制的关系。结果:PCOS组体质量指数(BMI)、卵泡刺激素(FSH)水平低于对照组,黄体生成激素(LH)、睾酮(TES)及黄体生成激素与卵泡刺激素的比值(LH/FSH)高于对照组,差异有统计学意义(P0.05)。PCOS组CYP17基因A1A1、A1A2、A2A2型频率分别为34.62%、41.92%、23.46%,与对照组的34.18%、43.88%、21.94%比较差异无统计学意义(P0.05);PCOS组等位基因A1、A2频率为55.58%、44.42%,与对照组的56.12%、43.88%比较差异无统计学意义(P0.05);PCOS组不同CYP17基因型者的FSH、LH及LH/FSH水平整体比较差异无统计学意义(P0.05);PCOS组BMI水平A2A2A1A2A1A1,TES水平A2A2A1A1A1A2,差异均有统计学意义(均P0.05);对照组不同CYP17基因型者的BMI、FSH、LH、TES及LH/FSH水平整体比较差异均无统计学意义(P0.05)。结论:CYP17基因-34bp处T/C单核苷酸多态性是人群中一种常见的碱基置换,与PCOS的发病机制无明显的相关性。     

游离睾酮指数联合血清GnSAF、SHBG对多囊卵巢综合征不孕患者IVF-ET治疗妊娠结局的预测价值

摘要 目的：探讨游离睾酮指数（FAI）联合血清促性腺激素平抑因子（GnSAF）、性激素结合球蛋白（SHBG）对多囊卵巢综合征（PCOS）不孕患者体外受精-胚胎移植（IVF-ET）治疗妊娠结局的预测价值。方法：选取2020年1月～2022年6月湖南省妇幼保健院生殖医学中心收治的197例PCOS不孕患者为PCOS组,根据IVF-ET治疗妊娠结局分为妊娠失败组和妊娠成功组,另选取同期68名体检健康妇女为对照组。收集PCOS不孕患者临床资料,计算FAI并检测血清GnSAF、SHBG水平。采用单因素和多因素Logistic回归分析PCOS不孕患者IVF-ET治疗妊娠结局的影响因素,采用受试者工作特征（ROC）曲线分析FAI和血清GnSAF、SHBG对PCOS不孕患者IVF-ET治疗妊娠结局的预测价值。结果：PCOS组FAI和血清GnSAF水平高于对照组,SHBG水平低于对照组（P＜0.05）。197例PCOS不孕患者IVF-ET治疗妊娠成功率为51.27%（101/197）。单因素分析显示,妊娠失败组体质指数、黄体生成素（LH）、LH/促卵泡生成素（FSH）、睾酮、抗苗勒管激素（AMH）、FAI、GnSAF高于妊娠成功组,FSH、受精率、优胚率、SHBG低于妊娠成功组（P＜0.05）。多因素Logistic回归分析显示,体质指数增加和LH、LH/FSH、AMH、FAI、GnSAF升高为PCOS不孕患者IVF-ET治疗妊娠失败的独立危险因素,SHBG升高为其独立保护因素（P＜0.05）。ROC曲线分析显示,FAI和血清GnSAF、SHBG联合预测PCOS不孕患者IVF-ET治疗妊娠结局的曲线下面积大于FAI、GnSAF、SHBG单独预测。结论：FAI和血清GnSAF、SHBG水平联合预测PCOS不孕患者IVF-ET治疗妊娠结局的价值较高。