Clinical, endocrine as well as metabolic characteristics and treatment of adolescent polycystic ovary syndrome
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摘要:目的 探讨青春期多囊卵巢综合征(PCOS)的临床特征、内分泌代谢特征及治疗。方法 选择105例青春期PCOS患者为研究对象, 分为常规组49例和联合组56例。收集2组患者的病史、体征及内分泌激素检测结果等资料，判断患者的临床特征与内分泌代谢特征。常规组采用雌激素治疗，联合组采用雌激素联合二甲双胍治疗。结果 青春期PCOS患者多伴有多毛、月经不规律、肥胖、痤疮等特征; 患者的内分泌代谢机制处于紊乱状态，卵泡雌激素、血清黄体生成素等内分泌激素水平普遍升高。联合组的总有效率显著高于常规组(P < 0.05); 治疗后，联合组的卵泡生成素、血清黄体生成素及睾酮水平均显著低于常规组(P < 0.05), 生活质量及焦虑情绪评分均显著优于常规组(P < 0.05), 空腹血糖、餐后2 h血糖水平均显著低于常规组(P < 0.05)。结论 雌激素联合二甲双胍治疗应用于青春期PCOS患者，可改善患者症状，纠正其内分泌代谢紊乱状态。Abstract:Objective To analyze the clinical, endocrine as well as metabolic characteristics and treatment of adolescent polycystic ovary syndrome (PCOS).Methods A total of 105 adolescent PCOS patients were divided into routine group(n=49) and combined group(n=56). The clinical features and endocrine metabolic characteristics of the two groups were analyzed by collecting clinical data such as medical history, signs and Results of endocrine hormone test. The routine group was given estrogen therapy, while combined group was additionally given metformin for the treatment.Results Adolescent PCOS patients were characterized by hirsutism, irregular menstruation, obesity and acne, who had disordered endocrine and metabolic mechanism, and increased levels of endocrine hormone such as follicular estrogen and serum luteinizing hormone. The total effective rate of the combined group was higher than that of the conventional group (P < 0.05). After treatment, the levels of follicle-forming hormone, serum luteinizing hormone and testosterone in the combined group were lower than that in the conventional group (P < 0.05). After treatment, the quality of life and anxiety scores in the combined group were better than those in the conventional group (P < 0.05), and the fasting and postprandial blood glucose in the combined group were lower than those in the conventional group (P < 0.05).Conclusion Estrogen combined with metformin in treatment of adolescent PCOS patients can improve their symptoms and correct their endocrine and metabolic disorders.
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表 1 2组患者疗效比较[n(%)]
组别 n 无效 有效 显效 总有效 常规组 49 8(16.33) 7(14.29) 34(69.39) 41(83.67) 联合组 56 2(3.57) 10(17.86) 44(78.57) 54(96.43)* 与常规组比较, *P < 0.05。 
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表 2 2组患者内分泌指标变化(x±s)
组别 卵泡雌激素/(IU/L) 血清黄体生成素/(IU/L) 睾酮/(nmol/L) 治疗前 治疗后 治疗前 治疗后 治疗前 治疗后 常规组 5.78±1.70 4.98±1.29 14.92±7.23 6.59±1.53 2.49±1.20 1.95±0.88 联合组 5.71±1.65 4.02±1.26* 14.78±7.26 4.04±0.99* 2.39±1.13 1.39±0.79* 与常规组比较, *P < 0.05。
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表 3 2组患者生活质量及焦虑情绪变化(x±s)
分 组别 n 生活质量评分 焦虑情绪评分 治疗前 治疗后 治疗前 治疗后 常规组 49 55.19±4.82 61.29±5.43 54.72±5.06 50.29±2.85 联合组 56 55.26±4.89 67.92±5.38* 54.79±5.10 46.16±3.05* 与常规组比较, *P < 0.05。
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表 4 2组患者血糖变化(x±s)
mmol/L 组别 n 空腹血糖 餐后2 h血糖 治疗前 治疗后 治疗前 治疗后 常规组 49 7.24±1.72 6.19±1.67 11.75±2.39 7.28±1.35 联合组 56 7.28±1.75 4.92±1.58* 11.71±2.43 6.19±1.23* 与常规组比较, *P < 0.05。
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