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青春期多囊卵巢综合征的诊断标准:文献综述

Criteria for Diagnosis of Polycystic Ovary Syndrome during Adolescence: Literature Review.

作者信息

Peña Alexia S, Codner Ethel, Witchel Selma

机构信息

Discipline of Paediatrics, The University of Adelaide Robinson Research Institute, 72 King William Road, Adelaide, SA 5006, Australia.

Endocrinology and Diabetes Department, Women's and Children's Hospital, 72 King William Road, Adelaide, SA 5006, Australia.

出版信息

Diagnostics (Basel). 2022 Aug 10;12(8):1931. doi: 10.3390/diagnostics12081931.

Abstract

Polycystic ovary syndrome (PCOS) is one of the most common endocrine conditions in women. PCOS may be more challenging to diagnose during adolescence due to an overlap with the physiological events of puberty, which are part of the diagnostic criteria in adult women. This review focuses on the evidence available in relation to PCOS diagnostic criteria for adolescents. Adolescent PCOS should be diagnosed using two main criteria irregular -menstrual cycles (relative to number of years post-menarche) and hyperandrogenism (clinical and/or biochemical); after excluding other conditions that mimic PCOS. Accurate definitions of the two main criteria will decrease challenges/controversies with the diagnosis and provide timely diagnosis during adolescence to establish early management. Despite the attempts to create accurate diagnostic criteria and definitions, this review highlights the limited research in this area, especially in the follow up of adolescents presenting with one diagnostic feature that are called "at risk of PCOS". Studies in adolescents continue to use the Rotterdam diagnostic criteria that uses pelvic ultrasound. This is inappropriate, because previous and emerging data that show many healthy adolescents have polycystic ovarian morphology in the early years post-menarche. In the future, anti-Müllerian hormone levels might help support PCOS diagnosis if adolescents meet two main criteria.

摘要

多囊卵巢综合征(PCOS)是女性中最常见的内分泌疾病之一。由于青春期的生理事件与成人女性的诊断标准存在重叠,PCOS在青春期的诊断可能更具挑战性。本综述聚焦于与青少年PCOS诊断标准相关的现有证据。青少年PCOS应使用两个主要标准进行诊断——月经周期不规律(相对于初潮后的年数)和高雄激素血症(临床和/或生化方面);在排除其他类似PCOS的疾病之后。这两个主要标准的准确定义将减少诊断方面的挑战/争议,并在青春期实现及时诊断以确立早期管理。尽管已尝试制定准确的诊断标准和定义,但本综述强调该领域的研究有限,尤其是在对具有一种诊断特征(即所谓“有PCOS风险”)的青少年的随访方面。针对青少年的研究仍在继续使用采用盆腔超声检查的鹿特丹诊断标准。这并不合适,因为既往和新出现的数据表明,许多健康青少年在初潮后的头几年都有多囊卵巢形态。未来,如果青少年符合两个主要标准,抗苗勒管激素水平可能有助于支持PCOS的诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0495/9406411/c3d7458a68df/diagnostics-12-01931-g001.jpg

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