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多囊卵巢综合征(PCOS)。

Polycystic ovary syndrome (PCOS).

机构信息

Service de gynécologie endocrinienne et de médecine de la reproduction, hôpital Jeanne-de-Flandre, Lille, France.

出版信息

Ann Endocrinol (Paris). 2010 Feb;71(1):8-13. doi: 10.1016/j.ando.2009.12.003. Epub 2010 Jan 22.

Abstract
  1. The Rotterdam classification should be used to define PCOS in the event of: menstrual cycle anomalies; amenorrhoea, oligomenorrhoea or long cycles, clinical and/or biochemical hyperandrogenism and ultrasound appearance of polycystic ovaries. 2. The presence of two of these three criteria is sufficient once all other diagnoses have been ruled out. 3. Diagnosis of hirsutism should not be based on the Ferriman-Gallway score. 4. The ultrasound definition of PCOS contains precise criteria that must be included in the report: presence of at least 12 follicles in each ovary measuring 2-9 mm in diameter, and/or increase in ovary size>10 ml. 5. Screening for elevated plasma LH no longer necessary. Testing for GnRH serves no purpose. 6. Routine screening for metabolic abnormalities should be carried out systematically based on weight, height and BMI, waist circumference, blood pressure and laboratory parameters: plasma glucose, triglycerides, HDL cholesterol. 7. In the case of obesity (BMI>30 kg/m(2)), oral glucose tolerance testing (OGTT) is recommended where fasting serum glucose is normal. 8. Clomiphene citrate (CC) remains the first-line therapy for ovulation induction. In patients with BMI>30, it should be preceded by improvement of metabolic status through appropriate lifestyle modifications.
摘要
  1. 如果存在以下情况,应使用 Rotterdam 分类来定义 PCOS:月经周期异常;闭经、稀发或周期延长;临床和/或生化高雄激素血症和多囊卵巢的超声表现。2. 排除所有其他诊断后,只要满足这三个标准中的两个,即可诊断。3. 不应根据 Ferriman-Gallway 评分来诊断多毛症。4. PCOS 的超声定义包含必须在报告中包含的精确标准:每个卵巢中至少有 12 个直径为 2-9 毫米的卵泡,和/或卵巢大小增加>10 毫升。5. 不再需要筛查升高的血浆 LH。测试 GnRH 没有意义。6. 应根据体重、身高和 BMI、腰围、血压和实验室参数(血浆葡萄糖、甘油三酯、HDL 胆固醇)系统地进行代谢异常的常规筛查。7. 在肥胖(BMI>30 kg/m²)的情况下,如果空腹血清葡萄糖正常,建议进行口服葡萄糖耐量试验(OGTT)。8. 枸橼酸氯米酚(CC)仍然是排卵诱导的一线治疗药物。对于 BMI>30 的患者,应通过适当的生活方式改变改善代谢状况,然后再使用 CC。

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