|
|
|
|
| 多毛女性的表型：多囊卵巢综合征与21-羟化酶缺乏非典型肾上腺增生的比较 |
|
|
|
|
|
| The phenotype of hirsute women: a comparison of polycystic ovary syndrome and 21-hydroxylase–deficient nonclassic adrenal hyperplasia |
|
|
|
|
|
| Pall, M, Azziz, R, Beires, J 2010/10/22 15:16:40 |
|
|
|
|
【发表评论】 【全球专家评论】
|
|
|
|
|
|
|
|
|
|
|
|
打印|
推荐给好友
|
|
|
|
|
|
|
|
| Fertil Steril, 2010, |
|
|
|
|
|
|
|
|
| View at Publisher |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Objective:
To test the hypothesis that women with polycystic ovary syndrome (PCOS) are distinguishable from those with 21-hydroxylase–deficient nonclassic adrenal hyperplasia on the basis of having polycystic ovaries and metabolic dysfunction.
Design:
Prospective observational.
Setting:
Tertiary care center.
Patient(s):
Fifty-two lean and 54 obese women with PCOS according to the 1990 National Institutes of Health criteria, 23 women with nonclassic adrenal hyperplasia, and 27 controls.
Intervention(s):
History and physical examination, blood sampling, ovarian sonography, oral glucose tolerance, and acute adrenocorticotropin stimulation testing.
Main Outcome Measure(s):
The frequency of clinical, biochemical, and metabolic features.
Result(s):
Women with PCOS had a higher frequency of oligomenorrhea or amenorrhea than those with nonclassic adrenal hyperplasia. Mean androstenedione and DHEAS levels were highest in nonclassic adrenal hyperplasia. The degree of metabolic dysfunction was greatest in obese women with PCOS; women with nonclassic adrenal hyperplasia and lean women with PCOS did not differ in degree of metabolic dysfunction. Women with nonclassic adrenal hyperplasia had a lower prevalence of polycystic ovaries than those with PCOS. The proportion of patients with an LH/FSH ratio >2 was greater in women with PCOS, compared with those with nonclassic adrenal hyperplasia. Basal 17-hydroxyprogesterone levels >2ng/mL were found in 87%, 25%, 20%, and 7% of women with nonclassic adrenal hyperplasia, lean women with PCOS, obese women with PCOS, and controls, respectively.
Conclusion(s):
Nonclassic adrenal hyperplasia should be excluded in all women presenting with hirsutism, with use of a basal follicular phase 17-hydroxyprogesterone level, regardless of the presence of polycystic ovaries or metabolic dysfunction; however, women with nonclassic adrenal hyperplasia have a higher prevalence of normal ovulation and lower likelihood of having an LH/FSH ratio >2 or polycystic ovaries (Table 3).
Table 3: Biochemical Features of Subjects |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
评论
|
|
|
|
请登录后发表评论，点击此处登录。
|
|
|
 疾病资源中心
病例分析 [栏目介绍]
王燕燕 王曙
上海交通大学附属瑞金医院内分泌科
患者，女，69岁。2009年1月无明显诱因下出现乏力，当时程度较轻，未予以重视。2009年3月患者乏力症状加重，尿色逐渐加深，大便习惯改变，颜色变淡。4月18日入我院感染科治疗，诉轻度头晕、心慌，体重减轻10kg。无肝区疼痛，无发热，无腹痛、腹泻、腹胀、里急后重，无恶性、呕吐等。入院半月前于外院就诊，查肝功能：ALT 601IU/L，AST 785IU/L，TBIL 97.7umol/L，白蛋白 41g/L，甲状腺功能：游离T3 30.6pmol/L，游离T4 51.9pmol/L，心电图示快速房颤。
医学数据库
|
