目的 探讨血清脂联素（ADPN）、糖类抗原125（CA125）及抗苗勒管激素（AMH）水平检测在多囊卵巢综合征（PCOS）中的临床诊断价值。方法 选取2022年1月—2022年9月在东莞市中医院经鹿特丹诊断标准确诊的100例PCOS患者作为PCOS组;PCOS组通过测定患者体质量指数（BMI）是否大于28 kg/m²分为肥胖组和非肥胖组;测定患者的睾酮水平的高低是否大于80 ng/dL分为高雄激素组和非高雄激素组。另选身体健康、年龄与PCOS组相近的100名健康女性作为对照组。分别测定PCOS组和对照组的ADPN、CA125以及AMH,分析血清ADPN、CA125、AMH在PCOS患者中的检测价值。结果 POCS组的BMI、AMH、CA125、睾酮、ADPN与健康组比较差异均有统计学意义（P<0.05）。与对照组比较,PCOS组的BMI、AMH、CA125、睾酮水平升高、ADPN水平降低。PCOS患者的CA125与AMH水平呈正相关（P<0.05）,ADPN与AMH无关（P>0.05）。结论 PCOS 患者血清CA125和AMH水平升高,ADPN水平降低。

Objective To explore the clinical diagnostic value of serum adiponectin（ADPN）,carbohydrate antigen 125（CA125）and anti-Mullerian hormone（AMH）levels in polycystic ovary syndrome（PCOS）．Method A total of 100 patients confirmed with PCOS in Dongguan Traditional Chinese Medicine Hospital from January 2022 to September 2022 were selected as the study subjects．All patients were diagnosed with PCOS according to the 2003 Rotterdam diagnostic criteria,and served as the PCOS group．The PCOS group was divided into obese and non obese group by measuring the patient’s body mass index（BMI）whether was greater than 28 kg/m²．A high androgen group and a non high androgen group were determined by whether the patient’s testosterone level is greater than 80 ng/dL．A hundred healthy women of similar age were selected as the healthy control group．The levels of ADPN,CA125 and AMH were measured in the experimental and control group,and their detection value were analyzed．Results BMI,AMH,CA125,testosterone and ADPN in the POCS group were statistically different compared to the healthy group（P<0.05）．Compared with the PCOS group,the control group showed a significant increase in BMI,AMH,CA125 and testosterone levels,while the PCOS group showed a decrease in ADPN level．There was a positive correlation between CA125 and AMH in patients with PCOS,while there was no correlation between ADPN and AMH．Conclusions The levels of serum CA125 and AMH in PCOS patients significantly increased,while the level of ADPN decreased．The three indicators have good diagnostic value in PCOS and are worth promoting．

目的 分析多囊卵巢综合征患者性激素水平与胰岛素抵抗关系。方法 此次研究所设置的观察组对象为我院收入的多囊卵巢综合征患者,均在2017年5月—2020年7月入院,入选患者共100例。选取同一时期到我院进行相关检查的健康育龄女性100例作为对照组。分别检测、统计2组女性的性激素[包括性激素黄体生成素(LH)、睾酮(T)、雌二醇(E2)、卵泡刺激素(FSH)]、空腹血糖(FBG)、空腹胰岛素(FINS)以及胰岛素抵抗指数,对性激素水平与胰岛素抵抗关系进行分析。结果 相比于对照组,观察组女性的LH、T水平更高(P＜0.05),E2、FSH水平更低(P＜0.05),且FBG、FINS、胰岛素抵抗指数均更高(P＜0.05)。观察组中,胰岛素抵抗与非胰岛素抵抗患者的性激素水平与胰岛素抵抗指数,胰岛素抵抗女性与非胰岛素抵抗女性的LH、TE2、FSH水平均具有差异(P＜0.05)。LH、E2、FSH水平与胰岛素抵抗指数无相关性(P＞0.05),T水平与胰岛素抵抗指数呈正相关(P＜0.05)。结论 多囊卵巢综合征患者的性激素出现了一定的分泌紊乱现象,其中T水平与胰岛素抵抗具有相关性。

Objective To analyze the relationship between sex hormone levels and insulin resistance in patients with polycystic ovary syndrome. Methods The subjects of the observation group set up in this study were patients with polycystic ovary syndrome admitted to our hospital, all of whom were admitted from May 2017 to July 2020, and a total of 100 patients were enrolled.One hundred healthy women of childbearing age who came to our hospital for relevant examinations during the same period were selected as the control group.Sex hormone [including luteinizing hormone (LH), testosteron (T), estradiol (E2), follicle stimulating hormone (FSH)] levels, fasting blood glucose (FBG) level, fasting insulin (FINS) level, and insulin resistance index were detected and summerized in the two groups of women separately, and the relationship between sex hormone levels and insulin resistance was analyzed. Results Compared with the control group, women in the observation group had higher LH and T levels (P<0.05), lower E2 and FSH levels (P<0.05), and higher FBG, FINS levels, and insulin resistance index (P<0.05). In the observation group, sex hormone levels and insulin resistance index in insulin-resistant and non-insulin-resistant patients, and LH, TE2, and FSH levels in insulin-resistant and non-insulin-resistant women were different (P<0.05). There was no correlation between LH, E2, and FSH levels and insulin resistance index (P> 0.05), and T level were positively correlated with insulin resistance index (P<0.05). Conclusion Patients with polycystic ovary syndrome showed some disturbance in the secretion of sex hormones, among which T level were correlated with insulin resistance.

目的 探讨青春期多囊卵巢综合征(PCOS)患者血清抗苗勒管激素(AMH)与25(OH)D₃水平的相关性。方法 本研究选择在2019年1月—2020年12月在我院妇科门诊就诊的PCOS青春期女性79名,另选择同期体检的非PCOS健康对照85名。对所有受试者测量身高、体质量,计算体质量指数(BMI)。由诊治医生检查研究对象是否有痤疮、多毛以及月经情况。抽取静脉血检测黄体生成素、卵泡刺激素、总睾酮、硫酸脱氢表雄酮、抗苗勒管激素和 25(OH)D₃,将 25(OH)D₃分为不足[25(OH)D₃<30 ng/mL]和缺乏[25(OH)D₃<20 ng/mL]2组,对数据进行比较分析。结果 与健康对照组比较,PCOS组更容易发生月经稀发/闭经,其痤疮发生率较高(P值均<0.05)。体质量指数、AMH值、总睾酮和硫酸脱氢表雄酮的体内检出水平在PCOS组较高,而25(OH)D₃在PCOS组较低(P值均<0.05)。PCOS组的AMH与BMI和总睾酮呈正相关关系,与25(OH)D₃呈负相关关系(P值均<0.05)。25(OH)D₃缺乏组的AMH水平高于25(OH)D₃不足组,对照组和PCOS组的25(OH)D₃缺乏组的AMH水平均高于25(OH)D₃不足组,两两比较其差异有统计学意义(P值均<0.05)。健康对照组的25(OH)D₃缺乏率为67.1%(57/85),而PCOS组的25(OH)D₃缺乏率为96.2%(76/79),2组比较其差异有统计学意义(χ²=22.68,P<0.001)。结论 青春期多囊卵巢综合征患者体内 25(OH)D₃水平与AMH 水平显著相关。AMH 和25(OH)D₃可用于评估青春期PCOS发病风险的替代指标。

Objective To explore the correlation between serum anti-Müllerian hormone (AMH) and 25(OH)D₃ levels in adolescent patients with polycystic ovary syndrome (PCOS). Methods Seventy-nine adolescent girls with PCOS and 85 non-PCOS healthy controls who walked in the gynecological clinic of our hospital from January 2019 to December 2020 were selected. Height, weight were measured and body mass index (BMI) was calculated.Hirsutism, acne and menstruation were evaluated by doctors on all subjects. Venous blood was drawn to detect levels of luteinizing hormone, follicle stimulating hormone, total testosterone, dehydroepiandrosterone sulfate, AMH and 25(OH)D₃, 25(OH)D₃ was further divided into insufficient [25(OH)D₃<30 ng/mL] and deficient [25(OH)D₃<20 ng/mL]level, then all data were compared and analyzed between two groups. Results Compared with the healthy control group, the PCOS group was more prone to have oligomenorrhea or amenorrhea, the incidence of acne was higher in PCOS group than in control group (all P values<0.05). BMI, the levels of AMH, total testosterone and dehydroepiandrosterone sulfate were significantly higher in the PCOS group compared to the control group, while 25(OH)D₃ was the opposite (all P values <0.05). AMH in the PCOS group was positively correlated with BMI and level of total testosterone, and negatively correlated with 25(OH)D₃ (all P values<0.05). The AMH level in the 25(OH)D₃ deficiency group was higher than that in the 25(OH)D₃ insufficient group, the AMH levels of the 25(OH)D₃ deficient group and control group were higher than that in the 25(OH)D₃ insufficient group,the differences were statistically significant (P<0.05). The 25(OH)D₃ deficiency rate in the healthy control group was 67.1% (57/85), while the 25(OH)D₃ deficiency rate in the PCOS group was 96.2% (76/79). The difference between the two groups was statistically significant (χ²=22.68, P<0.001). Conclusions Serum 25(OH)D₃ level was an independent factor significantly associated with AMH level in adolescents with PCOS. AMH and 25(OH)D₃ levels may be used as surrogate markers of PCOS risk in adolescents.

目的 探究炔雌醇环丙孕酮联合胰岛素增敏剂治疗多囊卵巢综合征疗效。方法 选取广东省第一荣军医院妇科2018年8月—2020年8月收治的100例多囊卵巢综合征患者作为研究对象,采用随机数字表法将患者分为对照组(n=50)和观察组(n=50),2组患者均给予炔雌醇环丙孕酮治疗,观察组此外联合胰岛素增敏剂治疗,比较2组患者治疗前、治疗30 d后血清性激素、抗缪勒管激素(AMH)水平、代谢指标水平以及临床疗效(包括排卵、妊娠等)。结果 治疗前,2组患者血清性激素、AMH水平比较,差异不具有统计学意义(P>0.05),治疗后,2组患者AMH、血清性激素水平均有所下降,且观察组低于对照组(P<0.05)。治疗前,2组患者代谢指标比较,差异不具有统计学意义(P>0.05),治疗后2组患者代谢指标水平均有所下降,且观察组低于对照组(P<0.05)。观察组治疗有效率高于对照组(P<0.05)。结论 使用单一药物治疗具有局限性,将炔雌醇环丙孕酮与胰岛素增敏剂相联合治疗能够有效降低患者胰岛素代谢指标水平以及性激素水平,提高患者受孕几率,具有良好的治疗效果。

Objective To explore the efficacy of ethinylestradiol and cyproterone combined with insulin sensitizer in the treatment of polycystic ovary syndrome. Methods A total of 100 patients with polycystic ovary syndrome treated in the Department of Gynecology of the First Invalids Hospital of Guangdong Province from August 2018 to August 2020 were selected as the research object. The patients were divided into control group (n=50) and observation group (n=50). The patients in both groups were given ethinylestradiol cyproterone. In addition, the observation group was treated with insulin sensitizer. The levels of serum sex hormone, anti-Müllerian hormone (AMH), metabolic index level and clinical efficacy (including ovulation, pregnancy, etc.) before treatment and 30 days after treatment were compared. Results Before treatment, the levels of serum sex hormone and AMH had no significant difference between two groups (P>0.05). After treatment, the levels of AMH and serum sex hormone both decreased in two groups, and those in observation group were lower than those in control group (P<0.05). Before treatment, it had no significant difference in metabolic indexes (P>0.05). After treatment, the levels of metabolic indexes in the two groups decreased, and those in observation group were lower than those in control group (P<0.05). The effective rate of the observation group was higher than the control group (P<0.05). Conclusions Using single drug treatment has limitations. The combination of ethinylestradiol cyproterone and insulin sensitizer can reduce insulin metabolism and sex hormone levels, improve the probability of pregnancy, which have a good therapeutic effect.

目的 对86例青春期多囊卵巢综合症(polycystic ovary syndrome,PCOS)患者进行随访,探讨患者长期治疗的依从性。方法 选择2009年11月—2012年6月在我院门诊首次诊断为青春期PCOS患者进行前瞻性队列研究。按随诊方法不同分为常规随访组和可及与连贯病人服务(ACC)组,前瞻随访6个月。分别在初次就诊时、3个月及6个月后对比两组的身体质量指数(Body Mass Index, BMI)、复诊率和遵医嘱服药率。结果 共86名患者入组,其中常规随访组43人,ACC组43人。两组基线资料基本一致。随访3月时,两组的BMI、复诊率和遵医嘱服药率的差异无统计学意义(P>0.05)。随诊6月时,ACC组的复诊率和服药依从性均优于常规随访组分别为(97.7% 比 81.4%,97.7% 比 76.7%,P＜0.05),BMI比常规随访组下降(22.33±7.31 比 24.59±7.8 kg/m²,t<0.05)。结论 可及与连贯的病人服务可以改善青春期PCOS患者BMI及长期随诊的复诊率和服药依从性。

Objective To investigate the compliance of adolescent patients with polycystic ovary syndrome (PCOS) in long-term treatment by access to care and continuity of care(ACC) on 86 cases. Methods A prospective cohort study was taken for 6 months on adolescent patients diagnosed as PCOS for the first time in out-patient department from November 2009 to June 2012. These patients were selected and divided into ACC group and regular follow-up group according to the different modes of follow-up visit. The relevant data including body mass index (BMI), clinic visit rate and rate of medication adherence were compared in the first visit and 3rd, 6th month in the follow-up visit. Results 86 patients were enrolled with 43 in ACC group and 43 in regular follow-up group. The baseline information was similar between the two groups. There were no statistically significant difference between groups in BMI, clinic visit rate and rate of medication adherence after 3 months (P>0.05). However, after 6 months, BMI, clinic visit rate and rate of medication adherence were significantly improved in the ACC group compared to the regular follow-up group (22.33±7.31 vs 24.59±7.8 kg/m², 97.7% vs 81.4%, 97.7% vs 76.7%, P＜0.05, respectively). Conclusion ACC could improve BMI, clinic visit rate and medication adherence of adolescent patients with polycystic ovary syndrome in long-term treatment.