Hunter M H, Sterrett J J
Medical University of South Carolina, Charleston, USA.
Am Fam Physician. 2000 Sep 1;62(5):1079-88, 1090.
Recent diagnostic and pharmacologic developments have focused renewed attention on polycystic ovary syndrome. Clinical features of the syndrome include anovulation, hyperandrogenism and menstrual dysfunction, but several other abnormalities, including hyperinsulinemia, luteinizing hormone hypersecretion, elevated testosterone levels and acyclic estrogen production, have been documented. Accompanying obesity and lipid abnormalities compound the risk of developing diabetes mellitus or cardiovascular disease, and chronic anovulation increases the risk for endometrial cancer. A careful history and physical examination should guide diagnostic testing. Slowly progressive hyperandrogenic symptoms with anovulation of peripubertal onset often represent polycystic ovary syndrome. Treatment goals include symptom management and the identification and prevention of potential cardiovascular risks. Treatment should take into account the patient's desire for fertility. Advances in transvaginal ultrasonography and infertility treatments, including newer medications, have facilitated assisted reproduction in patients with polycystic ovary syndrome. Ongoing pharmacologic research focusing on the treatment of insulin resistance appears promising in reversing the longterm complications of the syndrome.
近期诊断和药理学方面的进展使多囊卵巢综合征再次受到关注。该综合征的临床特征包括无排卵、高雄激素血症和月经功能紊乱，但也记录到其他一些异常情况，包括高胰岛素血症、促黄体生成素分泌过多、睾酮水平升高和无周期性雌激素产生。伴随的肥胖和脂质异常增加了患糖尿病或心血管疾病的风险，而慢性无排卵则增加了子宫内膜癌的风险。详细的病史和体格检查应指导诊断性检测。青春期前后开始出现的伴有无排卵的缓慢进展性高雄激素症状通常提示多囊卵巢综合征。治疗目标包括症状管理以及识别和预防潜在的心血管风险。治疗应考虑患者的生育意愿。经阴道超声检查和不孕症治疗方面的进展，包括新型药物，已促进了多囊卵巢综合征患者的辅助生殖。针对胰岛素抵抗治疗的持续药理学研究在逆转该综合征的长期并发症方面似乎前景乐观。
