CAJ | 학술논문

目的对育龄期癫痫妇女的生殖内分泌状况进行调查,并对生殖内分泌紊乱,尤其是多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者的临床特征进行系统分析,便于发现问题,及时干预.方法对139例育龄期女性癫痫患者进行人体测量学及体征评分、月经评估、性激素测定及盆腔超声检查,收集超重、中心性肥胖、月经稀发或闭经、黄体生成素(LH)/卵泡刺激素(FSH)、高雄激素血症、多囊卵巢(polycystic ovary,PCO)共6项指标,利用统计学方法分析其生殖内分泌紊乱的特征.结果 139例育龄期女性癫痫患者年龄(22.5±7.0)岁,其中30岁以下的处于生殖能力高峰的育龄女性占84.89%;患者中PCOS患病率达12.75%,明显高于我国普通育龄女性PCOS患病率.诊断PCOS特异度高的指标分别为高雄激素血症(100%)、LH/FSH＞2(93%)、月经稀发或闭经(90%);诊断灵敏度高的指标分别为PCO(92%)、月经稀发或闭经(85%)、高雄激素血症(54%).LH[PCOS组(10.24±6.92)IU/L,非PCOS组(4.16±2.62)IU/L,t=-3.899]、LH/FSH值[PCOS组(2.20±1.16),非PCOS组(0.87±0.56),t=-4.240)和睾酮水平[PCOS组(1.07±0.35)ng/ml,非PCOS组(0.46±0.25)ng/ml,t=-4.918]在PCOS组和非PCOS组之间的差异具有统计学意义(P＜0.01).结论性激素指标是诊断PCOS的客观指标;应重视对女性癫痫患者进行身高、体重、腹围、月经史、卵巢B超等指标的监测.当患者存在可疑生殖内分泌紊乱的临床特征时,必须检查性激素,以便及时发现异常,早期干预.
목적 대육령기전간부녀적생식내분비상황진행조사,병대생식내분비문란,우기시다낭란소종합정(polycystic ovary syndrome,PCOS)환자적림상특정진행계통분석,편우발현문제,급시간예.방법 대139례육령기녀성전간환자진행인체측량학급체정평분、월경평고、성격소측정급분강초성검사,수집초중、중심성비반、월경희발혹폐경、황체생성소(LH)/란포자격소(FSH)、고웅격소혈증、다낭란소(polycystic ovary,PCO)공6항지표,이용통계학방법 분석기생식내분비문란적특정.결과 139례육령기녀성전간환자년령(22.5±7.0)세,기중30세이하적처우생식능력고봉적육령녀성점84.89%;환자중PCOS환병솔체12.75%,명현고우아국보통육령녀성PCOS환병솔.진단PCOS특이도고적지표분별위고웅격소혈증(100%)、LH/FSH＞2(93%)、월경희발혹폐경(90%);진단령민도고적지표분별위PCO(92%)、월경희발혹폐경(85%)、고웅격소혈증(54%).LH[PCOS조(10.24±6.92)IU/L,비PCOS조(4.16±2.62)IU/L,t=-3.899]、LH/FSH치[PCOS조(2.20±1.16),비PCOS조(0.87±0.56),t=-4.240)화고동수평[PCOS조(1.07±0.35)ng/ml,비PCOS조(0.46±0.25)ng/ml,t=-4.918]재PCOS조화비PCOS조지간적차이구유통계학의의(P＜0.01).결론 성격소지표시진단PCOS적객관지표;응중시대녀성전간환자진행신고、체중、복위、월경사、란소B초등지표적감측.당환자존재가의생식내분비문란적림상특정시,필수검사성격소,이편급시발현이상,조기간예.
Objective To investigate the reproductive endocrine status of women with epilepsy at childbearing age and to systematically analyze the clinical features of reproductive endocrine disorders,especially polycystic ovarian syndrome (PCOS),to facilitate early detection and timely intervention.Methods In this study,scoring of anthropometry and physical signs,menstrul assessment,examination of sex hormone and pelvic ultrasound in women with epilepsy at childbearing age were performed,and the data such as overweight,central obesity,oligo/amenorrhea,luteinizing hormone (LH)/follicule-stimulating hormone (FSH),hyperandrogenism and polycystic ovary (PCO) were collected. The characteristics of their reproductive endocrine hormone disorders were analyzed statistically. Results The age of these patients was (22. 5 ± 7.0 ) years,and women younger than 30 years old and at their peak fertility accounted for 84. 89%. The prevalence rate of PCOS in women with epilepsy at childbearing age (12. 75% ) was significantly higher than that of ordinary women at childbearing age (7.2%) in China.Highly specific indicators for PCOS were hyperandrogenism (100%),LH/FSH ＞ 2 (93%) and oligo/amenorrhea (90%),whilst the highly sensitive indicators for PCOS were PCO (92%), oligo/amenorrhea (85%) and hyperandrogenism (54%). This study revealed statistically significant difference in LH,LH/FSH and testosterone (T) between PCOS group (LH: (10.24 ± 6.92) IU/L; LH/FSH;(2.20 ± 1.16);T: ( 1.07 ± 0. 35) ng/ml) and non-PCOS group ( LH: (4. 16 ± 2.62 ) IU/L; LH/FSH:( 0. 87 ± 0. 56 );T: (0. 46 ±0. 25) ng/ml,t = -3. 899,-4. 240 and -4. 918 respectively,all P ＜0. 01 ). Conclusions Hormone indices are objective indicators for the diagnosis of PCOS. In clinical practice,attention should be paid to height,weight,abodominal circumference,menstrul history and ultrasound examination of the ovary in women with epilepsy.When reproductive endocrine hormone disorders are suspected from clinical features,the sex hormones (T,LH,and FSH ) should be checked to allow timely detection and early interventions.