临床实践。多囊卵巢综合征。
CLINICAL PRACTICE. Polycystic Ovary Syndrome.
作者信息
McCartney Christopher R, Marshall John C
机构信息
From the Center for Research in Reproduction and the Division of Endocrinology and Metabolism, Department of Medicine, University of Virginia School of Medicine, Charlottesville.
出版信息
N Engl J Med. 2016 Jul 7;375(1):54-64. doi: 10.1056/NEJMcp1514916.
Abstract
A 22-year-old woman reports having hirsutism and irregular menses. She describes unpredictable and infrequent menses (five or six per year) since menarche at 11 years of age. Dark, coarse facial hair began to develop at 13 years of age. The symptoms worsened after she gained weight in college. The physical examination includes a body-mass index (BMI; the weight in kilograms divided by the square of the height in meters) of 29, blood pressure of 135/85 mm Hg, and moderate hirsutism without virilization. Laboratory tests reveal a total testosterone level of 65 ng per deciliter (2.3 nmol per liter) (assay reference range, 14 to 53 ng per deciliter [0.5 to 1.8 nmol per liter]), calculated free testosterone level of 15.3 pg per milliliter (53.1 pmol per liter) (assay reference range, 0.6 to 6.8 pg per milliliter [2.1 to 23.6 pmol per liter]), and glycated hemoglobin level of 5.7% (normal value, ≤5.6%). How should this case be evaluated and managed?
摘要
一名22岁女性报告有多毛症和月经不规律。她描述自11岁初潮以来月经不可预测且稀少（每年五或六次）。13岁时开始出现深色、粗糙的面部毛发。上大学体重增加后症状加重。体格检查包括体重指数（BMI；体重千克数除以身高米数的平方）为29，血压为135/85 mmHg，有多毛症但无男性化表现。实验室检查显示总睾酮水平为65 ng/dL（2.3 nmol/L）（检测参考范围为14至53 ng/dL [0.5至1.8 nmol/L]），计算得出的游离睾酮水平为15.3 pg/mL（53.1 pmol/L）（检测参考范围为0.6至6.8 pg/mL [2.1至23.6 pmol/L]），糖化血红蛋白水平为5.7%（正常值，≤5.6%）。该病例应如何评估和处理？
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